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Evaluation of left ventricular short- and long-axis function in severe mitral regurgitation using 2-dimensional strain echocardiography

Cited 31 time in Web of Science Cited 32 time in Scopus
Authors
Kim, Min-Seok; Kim, Yong-Jin; Kim, Hyung-Kwan; Han, Joo-Yong; Chun, Hong-Gu; Kim, Hee-Chan; Sohn, Dae-Won; Oh, Byung-Hee; Park, Young-Bae
Issue Date
2009-02-03
Publisher
Elsevier
Citation
Am Heart J. 2009 ;157(2):345-51.
Keywords
AdultAgedChronic DiseaseEchocardiographyEchocardiography, DopplerFemaleHumansMaleMiddle AgedMitral Valve Insufficiency/*physiopathology/ultrasonographyVentricular Dysfunction, Left/*physiopathology/ultrasonographyVentricular Function, Left/physiologyYoung Adult
Abstract
BACKGROUND: Few data exist on the changes in left ventricular (LV) short- and long-axis function and their usefulness as markers of LV contractile function in patients with chronic, severe mitral regurgitation (MR). METHODS: We studied 59 patients who had severe MR with an ejection fraction > or =50% and 34 healthy controls. Speckle tracking imaging was performed to measure peak systolic radial (SR(R)), circumferential (SR(C)), and longitudinal strain rates (SR(L)). In all patients, the peak rate of LV pressure rise (peak dP/dt) was measured using a micromanometer-tipped catheter. The patients were subdivided into patients with preserved (group 1, peak dP/dt > or =1,300 mm Hg/s [n = 30]) and depressed (group 2 [n = 29]) contractile function. RESULTS: SR(L) was significantly depressed in groups 1 and 2 when compared with the control group, but there was no difference between groups 1 and 2. In contrast, SR(R) and SR(C) were depressed only in group 2, whereas there were no differences between the control group and group 1. SR(R) and SR(C) correlated well with peak dP/dt (r = 0.71, P <.001 and r = -0.63, P <.001, respectively), whereas SR(L) did not. These findings suggest that LV long-axis function becomes depressed earlier than short-axis function in the chronic remodeling process. CONCLUSIONS: Left ventricular short-axis function is a useful marker of LV contractility in patients with chronic, severe MR. Left ventricular long-axis function becomes depressed earlier in the chronic remodeling process. Therefore, evaluation of short-axis as well as long-axis function might be important for better assessment of LV contractile function in these patients.
ISSN
1097-6744 (Electronic)
Language
English
URI
http://hdl.handle.net/10371/62335
DOI
https://doi.org/10.1016/j.ahj.2008.10.004
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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