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Effects of Mitral Balloon Valvuloplasty on Left Ventricular Systolic Functions: Assessment with Color Tissue Doppler

Year 2010, Volume: 13 Issue: 1, 16 - 19, 01.01.2009

Abstract

Objective: Left ventricular (LV) systolic functions are generally depressed in Mitral Stenosis (MS). Recovery of LV systolic functions demonstrated with 2D echocardiography in some patients by mitral balloon valvuloplasty (MBV). Systolic mitral annular velocity (S') by Tissue Doppler Imaging (TDI) predicts LV systolic function. We aimed to evaluate early effects of MBV on LV systolic function by TDI. Methods: Forty-eight consecutive patients included to the study (39 female, 36±10 years). A full transthoracic echocardiographic study (TTE) including left ventricular ejection fraction assessment by teicholz method and mitral annular color TDI assessment was performed 24 hours before and after MBV in all patients. MBV performed by ‹noue technique under guidance of TTE. Analysis of mitral lateral annular S' wave velocity was performed immediately after echocardiographic examination. Results: MBV performed successfully in 43 patients (Group A), and severe mitral regurgitation developed in 5 patients (Group B). Mitral valve area, and S' wave velocity increased, mean and maximum mitral gradient, and left atrial diameter, and systolic pulmonary artery pressure (PAP) were reduced significantly by MBV in group A patients (p

References

  • Mohan JC, Khalilullah M, Arora R. Left ventricular intrinsic contractility in pure rheumatic mitral stenosis. Am J Cardiol 1989; 64: 240-242.
  • Gash AK, Carabello BA, Cepin D, Spaan JF. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation 1983; 67:148-154.
  • Heller SJ, Carleton RA. Abnormal left ventricular contraction in patients with mitral stenosis. Circulation 1970; 42: 1099-l 110. 44.. Curry GC, Elliot EP, Ramsey HW. Quantitative left ventricu- lar angiographic findings in mitral stenosis. Am J Cardiol 1972; 29: 621-627.
  • Bolen JL, Lopes MG, Harrison DC, Alderman EL. Analysis of left ventricular function in response to afterload change in pa- tients with mitral stenosis. Circulation 1975; 52: 894-900.
  • Mohan JC, Nair M, Arora R. Left ventricular volumes and function immediately after balloon mitral valvuloplasty. Int J Cardiol 1991; 33: 275-280.
  • Goto S, Handa S, Akaishi M, Abe S, Ogawa S. Left vcntricu- lar ejection performance in mitral stenosis and effects of suc- cessful percutaneous transvenous mitral commissurotomy. Am J Cardiol 1992; 69: 233-237.
  • Tischler MD, St John Sutton M, Bittl JA, Parker JD. Effects of percutaneous mitral valvuloplasty on left ventricular mass and volume. Am J Cardiol 1991; 68: 940-944.
  • Wisenbaugh T, Essop R, Middlemost S, Skoularigis J, Sare- li P. Excessive vasoconstriction in rheumatic mitral stenosis with modestly reduced ejection fraction. J Am Col1 Cardiol 1992; 20: 1339-1344.
  • Bonow RO, Carabello BA, Kanu C, de Leon AC Jr, Faxon DP, Freed MD, et al. ACC/AHA 2006 guidelines for the mana- gement of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revi- se the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists. Circulation. 2006;114:e84–e231.
  • Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Fi- lippatos G, et al. Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur He- art J. 2007;28:230 –268.
  • Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommenda- tions regarding quantitation in M-mode echocardiography: re- sults of a survey of echocardiographic measurements. Circu- lation. 1978; 58: 1072–1083.
  • Henry WL, DeMaria A, Gramiak R, King DL, Kisslo JA, Popp RL, et al. Report of the American Society of Echocardi- ography Committee on nomenclature and standards in two- dimensional echocardiography. Circulation. 1980; 62: 212–217.
  • Inoue K. Percutaneous transvenous mitral commissuro- tomy using the Inoue balloon. Eur Heart J. 1991;12(suppl B):99 –108.
  • Iwanaga S, Handa S, Abe S, Nakamura Y, Kunieda E, Oga- wa K, et al. Left ventricular function in right ventricular overlo- ad asymmetry of the left ventricular ejection. Am J Cardiol 1989; 19: 487-498.
  • Pamir G, Ertafl F, Oral D, Gümüfl H, Omürlü K, Karaoguz R. Left ventricular filling and ejection fraction after successful percutaneous balloon mitral valvuloplasty. Int J Cardiol. 1997 May 23;59(3):243-6.
  • Mohan JC, Bhargava M, Agrawal R, Arora R. Effects of balloon mitral valvuloplasty on left ventricular muscle functi- on. Int J Cardiol. 1995 Mar 24;49(1):17-24.
  • Chetboul V, Escriou C, Tessier D, Richard V, Pouchelon JL, Thibault H, et al. Tissue Doppler imaging detects early asymptomatic myocardial abnormalities in a dog model of Duchenne's cardiomyopathy. Eur Heart J. 2004 Nov;25(21):1934-9.
  • Jassal DS, Othman RA, Ahmadie R, Fang T, Zieroth S, Fischer G, et al. The role of Tissue Doppler imaging in the no- ninvasive detection of chronic rejection after heterotopic car- diac transplantation in rats. Echocardiography. 2009 Jan;26(1):37-43.

Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi

Year 2010, Volume: 13 Issue: 1, 16 - 19, 01.01.2009

Abstract

Amaç: Sol ventrikül (SV) sistolik fonksiyonlar› mitral darl›¤› hastalar›nda genellikle bozulmufltur. Baflar›l› mitral balon valvuloplasti (MBV) ile SV sistolik fonksiyonlar›n›n baz› hastalarda düzeldi¤i konvansiyonel yöntemlerle tespit edilmifltir. Doku doppler (DD) ile mitral anulusdan elde edilen sistolik dalga (S')'n›n SV sistolik fonksiyonu ile olufltu¤ u ve h›z›n›n SV fonksiyonlar› ile korele oldu¤u gösterilmifltir. Bizde MBV ile SV sistolik fonksiyonlar›ndaki de¤iflimi DD ile de¤erlendirmeyi amaçlad›k. Metod: Ard›fl›k 48 hasta (39 kad›n, 36±10 y›l) çal›flmaya al›nd›. Tüm hastalara ifllemden önceki 24 saat içinde teicholz yöntemiyle SV ejeksiyon fraksiyonu (EF) ve renkli DD ile elde edilen mitral lateral anulusu S' dalga h›z› ölçümünün dahil oldu¤u ayr›nt›l› transtorasik ekokardiyografik (TTE) inceleme yap›ld›. MBV ‹noue tekni¤i ile TTE k›lavuzlu¤ unda yap›ld›. TTE MBV'den 24 saat sonra tekrarland›. Veriler paired sample t-test ile de¤erlendirildi. Bulgular: MBV 43 hastada baflar›l› (A grubu) olurken, 5 hastada ileri mitral yetersizli¤i (B grubu) geliflti. Her iki gruptaki hastalar›n kapak alanlar› anlaml› olarak artt›. A grubu hastalar›n ortalama ve maksimum mitral gradyentleri, sol atriyum çap›, sistolik pulmoner arter bas›nc› azal›rken, mitral kapak alan› ve mitral anuler S' dalga h›zlar› anlaml› olarak artt› (p

References

  • Mohan JC, Khalilullah M, Arora R. Left ventricular intrinsic contractility in pure rheumatic mitral stenosis. Am J Cardiol 1989; 64: 240-242.
  • Gash AK, Carabello BA, Cepin D, Spaan JF. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation 1983; 67:148-154.
  • Heller SJ, Carleton RA. Abnormal left ventricular contraction in patients with mitral stenosis. Circulation 1970; 42: 1099-l 110. 44.. Curry GC, Elliot EP, Ramsey HW. Quantitative left ventricu- lar angiographic findings in mitral stenosis. Am J Cardiol 1972; 29: 621-627.
  • Bolen JL, Lopes MG, Harrison DC, Alderman EL. Analysis of left ventricular function in response to afterload change in pa- tients with mitral stenosis. Circulation 1975; 52: 894-900.
  • Mohan JC, Nair M, Arora R. Left ventricular volumes and function immediately after balloon mitral valvuloplasty. Int J Cardiol 1991; 33: 275-280.
  • Goto S, Handa S, Akaishi M, Abe S, Ogawa S. Left vcntricu- lar ejection performance in mitral stenosis and effects of suc- cessful percutaneous transvenous mitral commissurotomy. Am J Cardiol 1992; 69: 233-237.
  • Tischler MD, St John Sutton M, Bittl JA, Parker JD. Effects of percutaneous mitral valvuloplasty on left ventricular mass and volume. Am J Cardiol 1991; 68: 940-944.
  • Wisenbaugh T, Essop R, Middlemost S, Skoularigis J, Sare- li P. Excessive vasoconstriction in rheumatic mitral stenosis with modestly reduced ejection fraction. J Am Col1 Cardiol 1992; 20: 1339-1344.
  • Bonow RO, Carabello BA, Kanu C, de Leon AC Jr, Faxon DP, Freed MD, et al. ACC/AHA 2006 guidelines for the mana- gement of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revi- se the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists. Circulation. 2006;114:e84–e231.
  • Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Fi- lippatos G, et al. Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur He- art J. 2007;28:230 –268.
  • Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommenda- tions regarding quantitation in M-mode echocardiography: re- sults of a survey of echocardiographic measurements. Circu- lation. 1978; 58: 1072–1083.
  • Henry WL, DeMaria A, Gramiak R, King DL, Kisslo JA, Popp RL, et al. Report of the American Society of Echocardi- ography Committee on nomenclature and standards in two- dimensional echocardiography. Circulation. 1980; 62: 212–217.
  • Inoue K. Percutaneous transvenous mitral commissuro- tomy using the Inoue balloon. Eur Heart J. 1991;12(suppl B):99 –108.
  • Iwanaga S, Handa S, Abe S, Nakamura Y, Kunieda E, Oga- wa K, et al. Left ventricular function in right ventricular overlo- ad asymmetry of the left ventricular ejection. Am J Cardiol 1989; 19: 487-498.
  • Pamir G, Ertafl F, Oral D, Gümüfl H, Omürlü K, Karaoguz R. Left ventricular filling and ejection fraction after successful percutaneous balloon mitral valvuloplasty. Int J Cardiol. 1997 May 23;59(3):243-6.
  • Mohan JC, Bhargava M, Agrawal R, Arora R. Effects of balloon mitral valvuloplasty on left ventricular muscle functi- on. Int J Cardiol. 1995 Mar 24;49(1):17-24.
  • Chetboul V, Escriou C, Tessier D, Richard V, Pouchelon JL, Thibault H, et al. Tissue Doppler imaging detects early asymptomatic myocardial abnormalities in a dog model of Duchenne's cardiomyopathy. Eur Heart J. 2004 Nov;25(21):1934-9.
  • Jassal DS, Othman RA, Ahmadie R, Fang T, Zieroth S, Fischer G, et al. The role of Tissue Doppler imaging in the no- ninvasive detection of chronic rejection after heterotopic car- diac transplantation in rats. Echocardiography. 2009 Jan;26(1):37-43.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ozlem Esen This is me

Ramazan Karg›n This is me

Selcuk Pala This is me

Yunus Em›roglu This is me

Zekeriya Kaya This is me

Cihan Dundar This is me

Ak›n Izgi This is me

Cevat Kirma This is me

Ali Metin Esen This is me

Publication Date January 1, 2009
Published in Issue Year 2010 Volume: 13 Issue: 1

Cite

APA Esen, O. ., Karg›n, R. ., Pala, S. ., Em›roglu, Y. ., et al. (2009). Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi. Koşuyolu Kalp Dergisi, 13(1), 16-19.
AMA Esen O, Karg›n R, Pala S, Em›roglu Y, Kaya Z, Dundar C, Izgi A, Kirma C, Esen AM. Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi. Koşuyolu Kalp Dergisi. January 2009;13(1):16-19.
Chicago Esen, Ozlem, Ramazan Karg›n, Selcuk Pala, Yunus Em›roglu, Zekeriya Kaya, Cihan Dundar, Ak›n Izgi, Cevat Kirma, and Ali Metin Esen. “Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler Ile De¤erlendirilmesi”. Koşuyolu Kalp Dergisi 13, no. 1 (January 2009): 16-19.
EndNote Esen O, Karg›n R, Pala S, Em›roglu Y, Kaya Z, Dundar C, Izgi A, Kirma C, Esen AM (January 1, 2009) Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi. Koşuyolu Kalp Dergisi 13 1 16–19.
IEEE O. . Esen, R. . Karg›n, S. . Pala, Y. . Em›roglu, Z. . Kaya, C. . Dundar, A. . Izgi, C. . Kirma, and A. M. . Esen, “Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi”, Koşuyolu Kalp Dergisi, vol. 13, no. 1, pp. 16–19, 2009.
ISNAD Esen, Ozlem et al. “Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler Ile De¤erlendirilmesi”. Koşuyolu Kalp Dergisi 13/1 (January 2009), 16-19.
JAMA Esen O, Karg›n R, Pala S, Em›roglu Y, Kaya Z, Dundar C, Izgi A, Kirma C, Esen AM. Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi. Koşuyolu Kalp Dergisi. 2009;13:16–19.
MLA Esen, Ozlem et al. “Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler Ile De¤erlendirilmesi”. Koşuyolu Kalp Dergisi, vol. 13, no. 1, 2009, pp. 16-19.
Vancouver Esen O, Karg›n R, Pala S, Em›roglu Y, Kaya Z, Dundar C, Izgi A, Kirma C, Esen AM. Mitral Balon Valvuloplastinin Sol Ventrikül Sistolik Fonksiyonlar› Üzerine Etkisinin Renkli Doku Doppler ile De¤erlendirilmesi. Koşuyolu Kalp Dergisi. 2009;13(1):16-9.