Early prediction of left ventricular systolic dysfunction in patients of asymptomatic chronic severe rheumatic mitral regurgitation using tissue Doppler and strain rate imaging

摘要

Aims: Identification of subclinical left ventricular (LV) dysfunction in patients with rheumatic mitral regurgitation (MR) facilitates optimal surgical results and better postoperative LV function. This study is designed to assess the role of tissue Doppler and strain rate (SR) imaging in early detection of LV systolic dysfunction in patients with asymptomatic chronic severe MR. Methods and results: Patients were studied under four groups. Group I: Normal subject (n=25). Group II: Patients with chronic severe MR with ejection fraction (EF) >60% and end-systolic dimension (ESD) <40mm (n=23). Group III: Patients with chronic severe MR with EF >60% and ESD 41-50mm (n=27). Group IV: Patients with chronic severe MR with EF<60% with any ESDs (n=25). With decrease in EF and increase in ESD there was decrease in systolic velocity and increased in precontraction time and contraction time was noted. The tissue Doppler systolic indices between groups were statistically significant P<0.05 and showed significant correlation value r=0.45 between groups. Strain (S) and SR significantly decreased with decrease in EF and increase in ESD P<0.05, r=0.45 between different groups.Conclusion: Our study showed significant correlation between tissue Doppler systolic indices and SR imaging with EF and ESD.