Document Detail

Pulsed tissue Doppler imaging detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation.
MedLine Citation:
PMID:  15020516     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess whether tissue Doppler myocardial imaging (TDI) indices can predict postoperative left ventricular function in patients with mitral regurgitation (MR) after surgical correction.
METHODS: 84 patients (mean (SD) age 54.3 (10.8) years) with asymptomatic severe MR, an end systolic diameter < 45 mm, and an ejection fraction (EF) > 60% were subdivided in two groups: 43 patients with a postoperative EF reduction < 10% (group 1) and 41 patients with a postoperative EF reduction > or = 10% (group 2).TDI systolic indices of the lateral annulus were analysed preoperatively to assess myocardial systolic wave (Sm) velocity, myocardial precontraction time (PCTm), myocardial contraction time (CTm), and the PCTm:CTm ratio.
RESULTS: Postoperative EF decreased significantly (from 67 (5)% to 60 (5.5)%, p = 0.0001). Group 2 had a higher PCTm, CTm, and PCTm:CTm ratio and a lower Sm velocity than group 1 (PCTm 100.4 (19) ms v 82 (21.8) ms, p = 0.004; CTm 222 (3.1) ms v 215 (2.3) ms, p = 0.01; PCTm:CTm 0.45 (0.08) v 0.38 (0.09), p = 0.001; Sm velocity 10.4 (1.1) cm/s v 13 (1.3) cm/s, p = 0.0001). Multivariate regression analysis showed that the combination of PCTm:CTm ratio > or = 40 ms and Sm velocity < or = 10.5 cm/s was the main independent predictor of postoperative EF reduction > or = 10% (sensitivity 78%, specificity 95%).
CONCLUSIONS: TDI systolic indices can predict postoperative left ventricular function in patients with asymptomatic MR undergoing surgical correction.
E Agricola; M Galderisi; M Oppizzi; A F L Schinkel; F Maisano; M De Bonis; A Margonato; A Maseri; O Alfieri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  90     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-15     Completed Date:  2004-04-23     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  406-10     Citation Subset:  AIM; IM    
Division of Non-Invasive Cardiology, San Raffaele Hospital, IRCCS, Milan, Italy.
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MeSH Terms
Cardiomyopathies / physiopathology,  ultrasonography*
Echocardiography, Doppler, Pulsed
Middle Aged
Mitral Valve Insufficiency / physiopathology,  surgery*
Postoperative Complications / ultrasonography*
Reproducibility of Results
Stroke Volume / physiology
Ventricular Dysfunction, Left / physiopathology,  ultrasonography*

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