Assessment of left ventricular fundion after mitral valve replacement by tissue Doppler imaging / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the clinical value of tissue Doppler imaging(TDI)in assessing left ventricular(LV)function after mitral valve replacement(MVR).Methods Forty-five patients having their implantations for more than three months were examined by echocardiography and divided into atrial fibrillation group(AF group,n=21)and sinus rhythm group(SR group,n=24).Thirty normal volunteers served as control group.Left atrium and ventricle indexs of cardiac function and mitral inflow velocity(E)were measured by two dimensional and Doppler echocardiography,and TDI-derived systolic mitral annular velocity(Sm),diastolic mitral annular velocity(Em)and isovolumic relaxation time(IVRT)were measured at the septal and lateral corners of mitral annulus from the apical four-chamber view.Then E/Em ratio was calculated.Results ①Compared with control group,Sm and Em in MVR group were significantly lower and IVRT was higher(P＜0.001),however there were no significant differences between AF group and SR group.② The E/Em ratio in MVR group was significantly higher than that in control group(P＜0.001)and positively correlated with IVRT.The best cutoff value for E/Em ratio was increased of 15 which yielded the sensitivity and specificity in predicting LV diastolic dysfunction were 91.11% and 90.32%,respectively.The area under the ROC curve was 0.9548±0.0402.Conclusions TDI-defived indexes(Sm,Em)can assess LV function accurately and the E/Em ratio,an estimate of myocardial relaxation and LV filling pressures,can be used to evaluate left ventricular diastolic function after MVR.