Effects of percutaneous mitral commissurotomy on longitudinal left ventricular dynamics in mitral stenosis: Quantitative assessment by tissue velocity imaging

Evaluation of the effect of mitral stenosis severity on the left ventricular systolic function using isovolumic myocardial acceleration

“…The presence of impaired left ventricular (LV) systolic function, determined by M-mode and/or two--dimensional (2D) echocardiography (ECHO), is noted in 25-30% of the patients with MS [2][3][4][5][6]. Recently, in the studies using tissue Doppler imaging (TDI) [7][8][9] and strain/strain rate imaging [10,11], which are more sensitive methods compared to the conventional ECHO, the occurrence of subclinical Mehmet Erturk et al, Severity of mitral stenosis and left ventricular function LV systolic dysfunction was confirmed even in MS patients with preserved ejection fraction (EF). The functional and/or myocardial factors, which cause impaired LV systolic function, are unclear.…”

“…In the study of Lee and Lee [12], systolic dysfunction of LV was suggested to be associated with the severity of myocardial involvement in isolated mitral valve stenosis during the rheumatic attack, not with the degree of the MS demonstrated by ECHO. Furthermore, Sengupta et al [8] showed that subclinical LV dysfunction improved following the percutaneous mitral valvuloplasty.…”

Subclinical left ventricular systolic dysfunction in patients with mild-to-moderate rheumatic mitral stenosis and normal left ventricular ejection fraction: an observational study

“…It has been reported in some studies that decreased preload, increased afterload and abnormal interventricular septal motion resulting from RV overload are responsible hemodynamic factors for decreased LV systolic performance. Sengupta et al (25) suggested that in MS patients with impaired LV EF, early after percutaneous mitral comissurotomy, significant improvement was observed in LV tissue Doppler velocities. This improvement was significantly correlated with mitral valve area.…”

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“…Increase of systolic and diastolic myocardial annular velocities was observed in patients after percutaneous balloon mitral valvuloplasty as evidence of reversibility of left ventricular performance in mitral stenosis after the relief of obstruction (13). Another evidence of longitudinal LV systolic dysfunction in patients with mild to moderate mitral stenosis was obtained with Doppler tissue imaging -derived annular peak systolic strain rate and end systolic strain, that both were significantly lower in patients with mitral stenosis (14).…”

“…Posterior wall systolic and diastolic velocities measured by M-mode echocardiography improved in the patients with mitral stenosis after open mitral commissurotomy (19). Improvement of annular myocardial velocities immediately after the percutaneous mitral valvuloplasty (13) indicates at least partial reversibility of left ventricular dysfunction after the relief of obstruction.…”