Pre and post percutaneous transvenous mitral commissorotomy assessment of ventricular functions in severe rheumatic mitral stenosis by tissue doppler imaging echocardiography

ABSTRACT

To evaluate the left and right ventricular functions in patients with rheumatic mitral stenosis by Doppler tissue imaging echocardiography technique before and 24 hours after percutaneous transvenous mitral commissurotomy. A total of 60 patients included in the study. Pre and Post Percutaneous Transvenous Mitral Commissurotomy of Left and Right Ventricular functions were assessed by calculating velocities at Mitral and Tricuspid Valve Annulus by using Tissue Doppler Imaging Echocardiography at Echo Wing of Cardiology unit LRH. The peak systolic velocities improved from 0.07 +/- 0.01 Pre to 0.085 +/- 0.01 Post Percutaneous Transvenous Mitral Commissurotomy with statistical significance [p-value=0.001] at Mitral valve annulus. Similarly early diastole and late diastolic velocities also showed statistically significant improvements at mitral annulus. Pre Percutaneous Transvenous Mitral Commissurotomy early diastolic velocity of 0.075 +/- 0.02 improved to 0.1 +/- 0.02 Post Percutaneous Transvenous Mitral Commissurotomy with a highly significant P-value of 0.001. For late diastole, p-value was also significant [Pre=0.11 +/- 0.02, Post=0.15 +/- 0.03, p-value=0.01]. An analysis of various velocities was also made at individual sites of mitral valve annulus i.e., septal, lateral, inferior and anterior sites. At all these sites, Post Percutaneous Transvenous Mitral Commissurotomy velocities were statistically significant with p-value less than 0.05. Tricuspid annular velocities did not show statistically significant improvements after 24 hours of Percutaneous Transvenous Mitral Commissurotomy. Systolic and diastolic velocities significantly improved after Percutaneous Transvenous Mitral Commissurotomy at mitral annulus, but this change was not observed at tricuspid annulus. It showed that Tissue Doppler Imaging Echocardiography aided in assessment of immediate improvement in left ventricular function after Percutaneous Transvenous Mitral Commissurotomy in patients suffering from severe mitral stenosis and in sinus rhythm