Document Detail


The role of left ventricular long axis contraction in patients with asymptomatic non-ischemic mitral valve regurgitation and normal systolic function.
MedLine Citation:
PMID:  17395299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several indices have been proposed in order to better evaluate chronic mitral regurgitation, however, none of them is unique, thus underlying the diagnostic deficiency. We aimed to investigate the role of long axis contraction in both ventricles in patients with non-ischemic asymptomatic mitral regurgitation (MR). METHODS: Eighty-nine patients (40 men, mean age 59.9+/-13.5 years) with non-ischemic asymptomatic MR along with 50 healthy controls were studied. An echocardiographic, including tissue Doppler imaging study, an exercise radionuclide cineangiography and a cardiac catheterization were also performed. RESULTS: Fifty of 89 patients (56.2%) had a normal response of left ventricular (LV) ejection fraction on exercise. LV end-diastolic diameter and volume index were significantly higher in patients with an impaired LV response. Moreover, systolic wave maximal velocity and systolic wave slope both at the lateral wall and at the inter-ventricular septum were significantly lower in patients with an impaired LV response. Systolic wave maximal velocity at the lateral wall was the index that best predicted LV response to exercise; while a cutoff value of 9.5 cm/s predicted an impaired LV response with a sensitivity of 96% and a specificity of 100%. MR as defined by the width of vena contracta, was mild/moderate in 78% of patients with a systolic wave maximal velocity at the lateral wall >9.5 cm/s and severe in 69.2% of patients with a velocity <9.5 cm/s. CONCLUSION: In patients with asymptomatic non-ischemic MR, the evaluation of LV long axis contraction at rest can unmask a subnormal LV functional status.
Authors:
Ioannis A Paraskevaidis; Stamatis Kyrzopoulos; Dimitrios Tsiapras; Efstathios K Iliodromitis; John Parissis; Dimitrios Farmakis; Dimitrios T Kremastinos
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Publication Detail:
Type:  Journal Article     Date:  2007-03-28
Journal Detail:
Title:  International journal of cardiology     Volume:  124     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-24     Completed Date:  2008-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  64-71     Citation Subset:  IM    
Affiliation:
Second Department of Cardiology, Athens University Medical School, Attiko University Hospital, Greece. elbee@ath.forthnet.gr
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Cineangiography
Echocardiography, Doppler
Exercise Test
Female
Heart Catheterization
Humans
Logistic Models
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology*,  ultrasonography
Myocardial Contraction / physiology*
Predictive Value of Tests
ROC Curve
Severity of Illness Index
Statistics, Nonparametric
Systole / physiology
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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