Turk Kardiyol Dern Ars. 2014; 42(1): 35-43 | DOI: 10.5543/tkda.2014.52711

Evaluation of the long-term effect of percutaneous balloon valvuloplasty on right ventricular function using tissue Doppler imaging in patients with mitral stenosis

Zekeriya Kaya¹, Hekim Karapınar², Hasan Kaya³, Özlem Batukan Esen⁴, Mustafa Akçakoyun⁵, Göksel Acar⁵, Ali Metin Esen⁵, Cevat Kırma^5
1Department of Cardiology, Harran University School of Medicine, Sanliurfa, Turkey
²Department of Cardiology, Cumhuriyet University School of Medicine, Sivas, Turkey
³Department of Cardiology, Dicle University School of Medicine, Diyarbakır, Turkey
⁴Department of Cardiology, Istanbul Memorial Hospital, Istanbul, Turkey
⁵Depdepartment of Cardiology, Kartal Kosuyolu Heart Education And Research Hospital, Turkey

OBJECTIVES
We investigated the effects of percutaneous mitral balloon valvuloplasty (PMBV) on right ventricular function in the long term using tissue Doppler imaging.

STUDY DESIGN
Twenty-seven patients who underwent successful PMBV were enrolled in the study. Echocardiographic examination, including color tissue Doppler imaging, was done from the lateral tricuspid annulus 24 hours before the intervention, and the examination was repeated 24 hours and 6 months after the intervention.

RESULTS
At 24 hours after the intervention, S wave velocity and A’ wave velocity were seen to have increased significantly (9.52±1.85 cm/s vs. 10.92±1.20 cm/s, p=0.012; -10.44±2.64 cm/s vs. -11.73±2.05 cm/s, p=0.029, respectively). E’ wave velocity and E’/A’ ratio did not change significantly (p>0.05 for both). In the late period, S wave velocity was similar to the value in the early period and significantly higher than the basal level (9.52±1.85 cm/s vs. 10.69±1.72 cm/s, p=0.023). However, A’ wave velocity in the late period was decreased compared to the early period and was not different from the basal level (-10.44±2.64 cm/s vs. -10.74±2.63 cm/s, p>0.05). The increase in E’ wave velocity in the late period when compared to the basal level was found to be statistically significant (-7.85±1.54 cm/s vs. -9.21±1.81 cm/s, p=0.046).

CONCLUSION
Right ventricular systolic function improved in the early period, and this improvement was seen to continue in the late period of PMBV. Diastolic function did not improve in the early period, but did improve in the late period. Right atrium systolic function improved in the early period; however, in the late period, levels were similar to the basal levels.

Keywords: Balloon dilatation/methods, balloon valvuloplasty, echocardiography, Doppler; heart catheterization; follow-up studies; mitral valve stenosis; ventricular dysfunction, right; ventricular function, right.

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