Turk Kardiyol Dern Ars. 2006; 34(1): 10-15

Evaluation of the global systolic and diastolic function of the left ventricle by the total ejection isovolume index following percutaneous mitral balloon valvuloplasty: a tissue Doppler imaging study

Nurcan Arat, Nesligül Yıldırım, Ümit Güray, Omaç Tüfekçioğlu, Şule Korkmaz, İrfan Sabah
Department of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara

OBJECTIVES
We evaluated the effect of percutaneous mitral balloon valvuloplasty (PMBV) on global systolic and diastolic functions of the left ventricle with the use of the total ejection isovolume (TEI) index.

STUDY DESIGN
The study included 76 consecutive patients (16 males, 60 females; median age 36 years; range 19 to 68 years) who underwent PMBV for isolated rheumatic mitral stenosis. Systolic and diastolic indexes were measured by pulsed Doppler tissue imaging echocardiography from the mitral lateral annulus and the TEI index was calculated before, and 48 hours and three months after PMBV.

RESULTS
Concerning diastolic function parameters, there was an improvement in the maximum early diastolic velocity (p=0.001), early and late diastolic velocity ratio (p=0.02), and a decrease in the isovolumetric relaxation time (p=0.02) immediately after PMBV. Maximum systolic velocity (p=0.01) improved as a systolic function parameter. Left ventricular global function did not improve significantly 48 hours (TEI indices 0.7±0.3 vs 0.5±0.2, p=0.06) and three months (0.7±0.3 vs. 0.6±0.2, p=0.97) after PMBV.

CONCLUSION
Parameters of mitral annular systolic and diastolic functions seem to be improved after PMBV, accompanied by an insignificant change in the TEI index. These changes in myocardial longitudinal functions may be due to the relief of functional restriction by the mobilization of the subvalvular apparatus.

Keywords: Balloon dilatation, blood flow velocity; echocardiography, Doppler, pulsed; heart function tests; mitral valve stenosis; myocardial contraction; ventricular function, left.

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