Effects of Mitral Balloon Valvuloplasty on Left Ventricular Systolic Functions: Assessment with Color Tissue Doppler

Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi

Ozlem ESEN,Ramazan KARGN,Selcuk PALA,Yunus EMROGLU,Zekeriya KAYA,Cihan DUNDAR,Akn IZGİ,Cevat KİRMA,Ali Metin ESEN

Abstract

Objective: Left ventricular (LV) systolic functions are generally depressed in Mitral Stenosis (MS). Recovery of LV systolic functions demonstrated with 2D echocardiography in some patients by mitral balloon valvuloplasty (MBV). Systolic mitral annular velocity (S') by Tissue Doppler Imaging (TDI) predicts LV systolic function. We aimed to evaluate early effects of MBV on LV systolic function by TDI. Methods: Forty-eight consecutive patients included to the study (39 female, 36±10 years). A full transthoracic echocardiographic study (TTE) including left ventricular ejection fraction assessment by teicholz method and mitral annular color TDI assessment was performed 24 hours before and after MBV in all patients. MBV performed by noue technique under guidance of TTE. Analysis of mitral lateral annular S' wave velocity was performed immediately after echocardiographic examination. Results: MBV performed successfully in 43 patients (Group A), and severe mitral regurgitation developed in 5 patients (Group B). Mitral valve area, and S' wave velocity increased, mean and maximum mitral gradient, and left atrial diameter, and systolic pulmonary artery pressure (PAP) were reduced significantly by MBV in group A patients (p

Özet

Amaç: Sol ventrikül (SV) sistolik fonksiyonlar mitral darl¤ hastalarnda genellikle bozulmufltur. Baflarl mitral balon valvuloplasti (MBV) ile SV sistolik fonksiyonlarnn baz hastalarda düzeldi¤i konvansiyonel yöntemlerle tespit edilmifltir. Doku doppler (DD) ile mitral anulusdan elde edilen sistolik dalga (S')'nn SV sistolik fonksiyonu ile olufltu¤ u ve hznn SV fonksiyonlar ile korele oldu¤u gösterilmifltir. Bizde MBV ile SV sistolik fonksiyonlarndaki de¤iflimi DD ile de¤erlendirmeyi amaçladk. Metod: Ardflk 48 hasta (39 kadn, 36±10 yl) çalflmaya alnd. Tüm hastalara ifllemden önceki 24 saat içinde teicholz yöntemiyle SV ejeksiyon fraksiyonu (EF) ve renkli DD ile elde edilen mitral lateral anulusu S' dalga hz ölçümünün dahil oldu¤u ayrntl transtorasik ekokardiyografik (TTE) inceleme yapld. MBV noue tekni¤i ile TTE klavuzlu¤ unda yapld. TTE MBV'den 24 saat sonra tekrarland. Veriler paired sample t-test ile de¤erlendirildi. Bulgular: MBV 43 hastada baflarl (A grubu) olurken, 5 hastada ileri mitral yetersizli¤i (B grubu) geliflti. Her iki gruptaki hastalarn kapak alanlar anlaml olarak artt. A grubu hastalarn ortalama ve maksimum mitral gradyentleri, sol atriyum çap, sistolik pulmoner arter basnc azalrken, mitral kapak alan ve mitral anuler S' dalga hzlar anlaml olarak artt (p

Keywords: Mitral darl¤, mitral balon valvuloplasti, sol ventrikül fonksiyonu, doku doppler görüntüleme