Changes in systolic left ventricular function in isolated mitral regurgitation. A strain rate imaging study.
Anna Marciniak1, Piet Claus, George R Sutherland
1Department of Cardiology and Cardiothoracic Surgery, St George's Hospital, London, UK.
European Heart Journal
|May 29, 2007
Summary
Strain rate (SR) imaging detects subclinical left ventricular (LV) systolic dysfunction in patients with mitral regurgitation (MR). Deformation decreases with severe MR, identifying patients at risk of irreversible myocardial damage.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Chronic isolated mitral regurgitation (MR) causes left ventricular (LV) dilatation and myocardial damage, increasing morbidity and mortality.
- Current methods lack specificity in detecting subclinical systolic dysfunction before irreversible damage occurs.
Purpose of the Study:
- To assess changes in LV regional systolic deformation using strain rate (SR) imaging in patients with isolated MR.
- To identify subclinical systolic dysfunction and patients at risk of irreversible myocardial damage.
Main Methods:
- Studied 54 asymptomatic patients with isolated non-ischaemic MR (mild, moderate, severe) and 23 healthy controls.
- Utilized standard echocardiography and tissue Doppler studies.
- Performed mathematical modeling to predict SR alterations with LV dimensions and myocardial damage.
Main Results:
- Peak systolic SR was significantly reduced in severe MR patients compared to others (P < 0.001 for all walls).
- Deformation correlated inversely with LV end-diastolic and end-systolic diameters.
- Geometry-corrected deformation measurements identified patients with increased risk (end-systolic diameter ≥ 4.5 cm).
Conclusions:
- LV deformation remains stable in mild to moderate MR due to compensatory mechanisms.
- Significant decreases in SR indicate declining contractility and potential irreversible myocardial damage.
- Geometry-corrected SR imaging may detect subclinical LV dysfunction in asymptomatic severe MR patients.
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