Pulsed tissue Doppler imaqinq detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation

E. Agricola, M. Galderisi, M. Oppizzi, A. F L Schinkel, F. Maisano, M. De Bonis, A. Margonato, A. Maseri, O. Alfieri

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Abstract

Objective: To assess whether tissue Doppler myocardial imaging (TDI) indices can predict postoperative left ventricular function in patients with mitral regurgitation (MR) after surgical correction. Methods: 84 patients (mean (SD) age 54.3 (10.8) years) with asymptomatic severe MR, an end systolic diameter <45 mm, and an ejection fraction (EF) > 60% were subdivided in two groups: 43 patients with a postoperative EF reduction <10% (group 1) and 41 patients with a postoperative EF reduction ≥ 10% (group 2). TDI systolic indices of the lateral annulus were analysed preoperatively to assess myocardial systolic wave (Sm) velocity, myocardial precontraction time (PCTm), myocardial contraction time (CTm), and the PCTm:CTm ratio. Results: Postoperative EF decreased significantly (from 67 (5)% to 60 (5.5)%, p = 0.0001). Group 2 had a higher PCTm, CTm, and PCTm:CTm ratio and a lower Sm velocity than group 1 (PCTm 100.4 (19) ms v 82 (21.8) ms, p = 0.004; CTm 222 (3.1) ms v 215 (2.3) ms, p = 0.01; PCTm:CTm 0.45 (0.08) v 0.38 (0.09), p = 0.001; Sm velocity 10.4 (1.1) cm/s v 13 (1.3) cm/s, p = 0.0001). Multivariate regression analysis showed that the combination of PCTm:CTm ratio ≥ 40 ms and Sm velocity ≤ 10.5 cm/s was the moin independent predictor of postoperative EF reduction ≥ 10% (sensitivity 78%, specificity 95%). Conclusions: TDI systolic indices can predict postoperative left ventricular function in patients with asymptomatic MR undergoing surgical correction.

Original languageEnglish
Pages (from-to)406-410
Number of pages5
JournalHeart
Volume90
Issue number4
Publication statusPublished - Apr 2004

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Mitral Valve Insufficiency
Left Ventricular Function
Myocardial Contraction
Multivariate Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Pulsed tissue Doppler imaqinq detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation. / Agricola, E.; Galderisi, M.; Oppizzi, M.; Schinkel, A. F L; Maisano, F.; De Bonis, M.; Margonato, A.; Maseri, A.; Alfieri, O.

In: Heart, Vol. 90, No. 4, 04.2004, p. 406-410.

Research output: Contribution to journalArticle

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title = "Pulsed tissue Doppler imaqinq detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation",
abstract = "Objective: To assess whether tissue Doppler myocardial imaging (TDI) indices can predict postoperative left ventricular function in patients with mitral regurgitation (MR) after surgical correction. Methods: 84 patients (mean (SD) age 54.3 (10.8) years) with asymptomatic severe MR, an end systolic diameter <45 mm, and an ejection fraction (EF) > 60{\%} were subdivided in two groups: 43 patients with a postoperative EF reduction <10{\%} (group 1) and 41 patients with a postoperative EF reduction ≥ 10{\%} (group 2). TDI systolic indices of the lateral annulus were analysed preoperatively to assess myocardial systolic wave (Sm) velocity, myocardial precontraction time (PCTm), myocardial contraction time (CTm), and the PCTm:CTm ratio. Results: Postoperative EF decreased significantly (from 67 (5){\%} to 60 (5.5){\%}, p = 0.0001). Group 2 had a higher PCTm, CTm, and PCTm:CTm ratio and a lower Sm velocity than group 1 (PCTm 100.4 (19) ms v 82 (21.8) ms, p = 0.004; CTm 222 (3.1) ms v 215 (2.3) ms, p = 0.01; PCTm:CTm 0.45 (0.08) v 0.38 (0.09), p = 0.001; Sm velocity 10.4 (1.1) cm/s v 13 (1.3) cm/s, p = 0.0001). Multivariate regression analysis showed that the combination of PCTm:CTm ratio ≥ 40 ms and Sm velocity ≤ 10.5 cm/s was the moin independent predictor of postoperative EF reduction ≥ 10{\%} (sensitivity 78{\%}, specificity 95{\%}). Conclusions: TDI systolic indices can predict postoperative left ventricular function in patients with asymptomatic MR undergoing surgical correction.",
author = "E. Agricola and M. Galderisi and M. Oppizzi and Schinkel, {A. F L} and F. Maisano and {De Bonis}, M. and A. Margonato and A. Maseri and O. Alfieri",
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T1 - Pulsed tissue Doppler imaqinq detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation

AU - Agricola, E.

AU - Galderisi, M.

AU - Oppizzi, M.

AU - Schinkel, A. F L

AU - Maisano, F.

AU - De Bonis, M.

AU - Margonato, A.

AU - Maseri, A.

AU - Alfieri, O.

PY - 2004/4

Y1 - 2004/4

N2 - Objective: To assess whether tissue Doppler myocardial imaging (TDI) indices can predict postoperative left ventricular function in patients with mitral regurgitation (MR) after surgical correction. Methods: 84 patients (mean (SD) age 54.3 (10.8) years) with asymptomatic severe MR, an end systolic diameter <45 mm, and an ejection fraction (EF) > 60% were subdivided in two groups: 43 patients with a postoperative EF reduction <10% (group 1) and 41 patients with a postoperative EF reduction ≥ 10% (group 2). TDI systolic indices of the lateral annulus were analysed preoperatively to assess myocardial systolic wave (Sm) velocity, myocardial precontraction time (PCTm), myocardial contraction time (CTm), and the PCTm:CTm ratio. Results: Postoperative EF decreased significantly (from 67 (5)% to 60 (5.5)%, p = 0.0001). Group 2 had a higher PCTm, CTm, and PCTm:CTm ratio and a lower Sm velocity than group 1 (PCTm 100.4 (19) ms v 82 (21.8) ms, p = 0.004; CTm 222 (3.1) ms v 215 (2.3) ms, p = 0.01; PCTm:CTm 0.45 (0.08) v 0.38 (0.09), p = 0.001; Sm velocity 10.4 (1.1) cm/s v 13 (1.3) cm/s, p = 0.0001). Multivariate regression analysis showed that the combination of PCTm:CTm ratio ≥ 40 ms and Sm velocity ≤ 10.5 cm/s was the moin independent predictor of postoperative EF reduction ≥ 10% (sensitivity 78%, specificity 95%). Conclusions: TDI systolic indices can predict postoperative left ventricular function in patients with asymptomatic MR undergoing surgical correction.

AB - Objective: To assess whether tissue Doppler myocardial imaging (TDI) indices can predict postoperative left ventricular function in patients with mitral regurgitation (MR) after surgical correction. Methods: 84 patients (mean (SD) age 54.3 (10.8) years) with asymptomatic severe MR, an end systolic diameter <45 mm, and an ejection fraction (EF) > 60% were subdivided in two groups: 43 patients with a postoperative EF reduction <10% (group 1) and 41 patients with a postoperative EF reduction ≥ 10% (group 2). TDI systolic indices of the lateral annulus were analysed preoperatively to assess myocardial systolic wave (Sm) velocity, myocardial precontraction time (PCTm), myocardial contraction time (CTm), and the PCTm:CTm ratio. Results: Postoperative EF decreased significantly (from 67 (5)% to 60 (5.5)%, p = 0.0001). Group 2 had a higher PCTm, CTm, and PCTm:CTm ratio and a lower Sm velocity than group 1 (PCTm 100.4 (19) ms v 82 (21.8) ms, p = 0.004; CTm 222 (3.1) ms v 215 (2.3) ms, p = 0.01; PCTm:CTm 0.45 (0.08) v 0.38 (0.09), p = 0.001; Sm velocity 10.4 (1.1) cm/s v 13 (1.3) cm/s, p = 0.0001). Multivariate regression analysis showed that the combination of PCTm:CTm ratio ≥ 40 ms and Sm velocity ≤ 10.5 cm/s was the moin independent predictor of postoperative EF reduction ≥ 10% (sensitivity 78%, specificity 95%). Conclusions: TDI systolic indices can predict postoperative left ventricular function in patients with asymptomatic MR undergoing surgical correction.

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VL - 90

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EP - 410

JO - Heart

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SN - 1355-6037

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