Study Of Ventricular Function In Patients With Rheumatic Valvular Heart Disaese

Ventricular Function In Patients With Rheumatic Valvular Heart Disease

Authors

  • Mangesh Mekha
  • Hetal Patel

Keywords:

TDE- Tissue Doppler Echocardiography,MS-Mitral stenosis

Abstract

Objective: In India, the commonest cardiovascular ailment encountered in hospitals is rheumatic heart disease, mitral valve being most commonly affected. Rheumatic mitral valve disease affects left-ventricular performance as a result of myocardial and functional factors. This study is aims to review the use of Tissue Doppler Echocardiography over conventional echocardiography in assessment of ventricular functions in patients having rheumatic heart disease. Material and Methods: This is a cross sectional study carried out at Shree Sayajirao General Hospital and Medical College Baroda. Total of 35 patients with an established diagnosis of rheumatic MS, and 30 age-matched healthy individuals were included in this study. Echocardiography equipped with TDE function was performed on each participant. The mitral valve area, gradient across mitral valve, Left atrial size, ejection fraction, isovolumic contraction time of ventricles, myocardial velocity of ventricular walls were measured. Discussion: The average age of study population was 33 years with 57% females patients and 43% males patients. There was maximum correlation between Systolic myocardial velocity and ejection fraction calculated by Simpson’s Four Chamber method . Regional distribution of systolic dysfunction occur in rheumatic mitral valve disease with maximum maximum affection of posterior and lateral wall and minimal affection of interventricular septum. LV systolic and diastolic dysfunction can occur in pure mitral stenosis independent of severity of mitral stenosis & Tissue Doppler echocardiography appears to be feasible in the prediction of subclinical LV dysfunction.

References

1. Lee TM, Su SF, Chen MF, Liau CS, Lee YT. Changes of left ventricular function after percutaneous balloon mitral valvuloplasty in mitral stenosis with impaired left ventricular performance. Int J Cardiol 1996
2. Gaasch WH, Folland ED. Left ventricular function in rheumatic mitral stenosis. Eur Heart J 1991;12:66-9.
3. Gash AK, Carebello BA, Cepin D, Spann JF. Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. Circulation 1983;67:148-54
4. Feigenbaum's Echocardiography, 6th EditionDonovan CL, Armstrong WF, Bach DS. Quantitative Doppler tissue imaging of the left
ventricular myocardium: validation in normal subjects. Am Heart J 1995;130:100-4.
5. Kossoff G. Diagnostic Applications of Ultrasound in Cardiology, Australia Radiol 1966;10 : 101.
6. Olson, LJ, Subramanian, R, Ackermann, DM, et al. Surgical pathology of the mitral valve: a study of 712 cases spanning 21 years. Mayo Clin Proc 1987; 62:22
7. Horstkotte, D, Niehues, R, Strauer, BE. Pathomorphological aspects, aetiology and natural history of acquired mitral valve stenosis. Eur Heart J 1991; 12 Suppl B:55.
8. Alam M, Wardell J, Andersson E, Samad BA, Nordlander R. Effects of first myocardial infarction on left ventricular systolic and diastolic function with the use of mitral annular velocity determined by pulsed wave Doppler tissue imaging. J Am Soc Echocardiogr 2000;13:343-52.
9. Wood, P. An appreciation of mitral stenosis. I. Clinical features. Br Med J 1954; 4870:1051.
10. Gordon, SP, Douglas, PS, Come, PC, Manning, WJ. Two-dimensional and Doppler echocardiographic determinants of the natural history of mitral valve narrowing in patients with rheumatic mitral stenosis: implications for follow-up. J Am Coll Cardiol 1992; 19:968.
11. Chiang, CW, Lo, SK, Ko, YS, et al. Predictors of systemic embolism in patients with mitral stenosis. Ann Intern Med 1998; 128:885.
12. Roberts, WC, Braunwald, E, Morrow, AG. Acute severe mitral regurgitation secondary to ruptured chordae tendineae: clinical, hemodynamic, and pathologic considerations. Circulation 1966; 33:58.
13. Lehmann, KG, Francis, CK, Dodge, HT. Mitral regurgitation in early myocardial infarction. Incidence, clinical detection, and prognostic implications. TIMI Study Group. Ann Intern Med 1992; 117:10.

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Published

2013-02-28

How to Cite

Mekha, M., & Patel, H. (2013). Study Of Ventricular Function In Patients With Rheumatic Valvular Heart Disaese: Ventricular Function In Patients With Rheumatic Valvular Heart Disease. National Journal of Integrated Research in Medicine, 4(1), 22–28. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/2122

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Original Articles