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

摘要

Background: Mitral stenosis (MS) is still the most common complication of acute rheumatic fever in Turkey. Rheumatic carditis affects not only cardiac valves but also myocardium. In this study, we aimed to evaluate the subclinical left ventricular (LV) systolic dysfunction and contraction of short and long axial circumferential and longitudinal fibers by pulsed wave tissue Doppler in rheumatic MS patients who have preserved LV systolic function in 2D echocardiography.Methods: Fifteen severe, 20 moderate rheumatic MS patients hospitalized for mitral balloon valvuloplasty, and 15 patients who had normal echocardiographic findings were included in the study. After routine conventional transthoracic echocardiographic examination, LV myocardial systolic velocities were evaluated with pulsed wave tissue Doppler in the short and long axis with simultaneous electrocardiographic monitoring.Results: Long axis first systolic velocity (SW1) of mild-moderate and severe MS was much lower than normal group (10.7 ± 2.3 in normal group vs. 7.9 ± 1.3 in mild-moderate MS group vs. 6.2 ± 1.4 in severe MS group, p Conclusions: Even if LV functions are normal with conventional 2D echocardiography, subclinical systolic dysfunction exists in MS. Also, there is a dyssynchrony between contraction of longitudinal and circumferential myofibrils.