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

Cardiol J. 2014;21(4):442-8. doi: 10.5603/CJ.a2013.0114. Epub 2013 Aug 30.

Abstract

Background: Isovolumic acceleration (IVA) is a new tissue Doppler parameter in the assessment of systolic function of both left and right ventricles. It remains unaffected with the changes in pre- and after-load within the physiological range. The aim of our study was to assess the effect of mitral stenosis degree, which is determined by echocardiography, on the left ventricular (LV) function using IVA.

Methods: A total number of 62 patients with mitral stenosis (MS) and 32 healthy controls were examined. The severity of MS (mild, moderate, and severe) was determined on the basis of mitral valve area (MVA) and the mean diastolic mitral gradient findings. The peak myocardial velocities during isovolumic contraction, systole, early diastole and late diastole were measured by using tissue Doppler imaging (TDI).

Results: All TDI-derived global LV basal wall systolic (peak myocardial isovolumic contraction velocity, peak myocardial systolic velocity and IVA), and diastolic velocities (peak early and late diastolic velocities) were significantly decreased in the patients with MS, compared to the healthy patients (p < 0.001, for all). However, IVA was not different when the degree of MS was evaluated (p = 0.114). In addition, IVA was not correlated with the MVA (r = 0.185, p = 0.150).

Conclusions: Left ventricular function is impaired in patients with MS regardless of the severity of the disease.

MeSH terms

  • Acceleration
  • Adult
  • Biomechanical Phenomena
  • Case-Control Studies
  • Echocardiography, Doppler*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / diagnostic imaging*
  • Mitral Valve / physiopathology
  • Mitral Valve Stenosis / complications
  • Mitral Valve Stenosis / diagnostic imaging*
  • Mitral Valve Stenosis / physiopathology
  • Predictive Value of Tests
  • Severity of Illness Index
  • Systole*
  • Time Factors
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left*