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Evaluation of left ventricular systolic function with pulsed wave tissue Doppler in rheumatic mitral stenosis

Saadet Guven, Taner Sen1, Omac Tufekcioglu

  • 1Department of Cardiology, Dumlupinar University Kutahya Evliya Celebi Education and Research Hospital, Turkey. medicineman_tr@hotmail.com.

Cardiology Journal
|June 27, 2013
PubMed
Abstract

Insights

Subclinical systolic dysfunction is present in patients with mitral stenosis (MS), even with normal 2D echocardiography. Pulsed wave tissue Doppler reveals impaired myocardial fiber contraction and dyssynchrony in rheumatic MS.

Area of Science:

  • Cardiology
  • Echocardiography
  • Rheumatic Heart Disease

Background:

  • Mitral stenosis (MS) is a common complication of acute rheumatic fever in Turkey.
  • Rheumatic carditis can affect cardiac valves and myocardium.
  • This study investigates subclinical left ventricular (LV) dysfunction in rheumatic MS patients.

Purpose of the Study:

  • To evaluate subclinical LV systolic dysfunction in rheumatic MS patients.
  • To assess myocardial fiber contraction using pulsed wave tissue Doppler.
  • To identify dysfunction in patients with preserved LV systolic function on 2D echocardiography.

Main Methods:

  • Inclusion of 15 severe MS, 20 moderate MS, and 15 healthy control patients.
  • Conventional transthoracic echocardiography followed by pulsed wave tissue Doppler analysis.
  • Evaluation of LV myocardial systolic velocities in short and long axes with ECG monitoring.

Main Results:

  • Long axis systolic velocity (SW1) was significantly lower in mild-moderate and severe MS groups compared to controls.
  • Long axis Q-SW1 duration was prolonged in the mild-moderate MS group.
  • Short axis Q-SW2 duration was shorter in MS groups compared to controls, indicating dyssynchrony.

Conclusions:

  • Subclinical systolic dysfunction exists in MS patients, even with normal 2D echocardiography findings.
  • There is evidence of dyssynchrony between longitudinal and circumferential myocardial fiber contraction in MS.
  • Pulsed wave tissue Doppler is valuable for detecting early myocardial dysfunction in MS.

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