Additional features of echocardiographic assessment of left ventricular systolic function inpatients with moderate mitral regurgitation before and after surgical myocardial revascularizationand mitral annuloplasty

Authors: S.G. Sukhanov 1,2, 2, E.N. Orekhova 1,2, 2, S.A. Sharlaimov 2

Company: 1 Аcademician E.A. Wagner Perm State Medical Academy of Ministry of Health of the Russian Federation; ulitsa Petropavlovskaya, 26, Perm, 614000, Russian Federation; 2 Federal Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation; ulitsa Marshala Zhukova, 35, Perm, 614013, Russian Federation


For citation: Sukhanov S.G., Orekhova E.N., Sharlaimov S.A. Additional features of echocardiographic assessment of left ventricular systolic function in patients with moderate mitral regurgitation before and after surgical myocardial revascularization and mitral annuloplasty. Creative Cardiology. 2014; 1: 24-35

Keywords: longitudinal strain systolic function mitral annuloplasty

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Abstract

Purpose. Comprehensive echocardiographic assessment of left ventricular (LV) systolic function in patients with moderate mitral regurgitation before and after surgical revascularization and mitral annuloplasty. Material and methods. The study involved 58 patients with moderate mitral insufficiency and no signs of significant left ventricular remodeling. Depending on the operating surgeon tactics against further intervention on the mitral valve patients were divided into 2 groups of observations: group 1 (n=28) – isolated coronary artery bypass grafting; group 2 (n=30) – coronary artery bypass grafting and mitral annuloplasty. In echocardiographic evaluation included standard measurement and assessment of global and segmental left ventricular function, as well as the use of techniques speckle tracking and tissue Doppler to measure speed of the fibrous ring of the mitral valve. Results. The result was a significant decrease in overall left ventricular ejection fraction (LVEF) in group 2 in the early postoperative period. In the mid-term total LVEF has improved, but did not reach baseline values. Also in the early period of observation calculated LVEF showed significant improvement compared with baseline, but did not change significantly with further observation and was comparable to the control group. Compared with the original data in the early period of observation there was a reduction of global longitudinal strain in both groups, but more pronounced in group 2. In the medium to longterm follow global longitudinal strain showed an increase, but remained lower than baseline. Conclusions. Some parameters, such as left ventricular end-systolic volume, are dependent on afterload affect the accuracy in the evaluation of left ventricular systolic function to mitral valve annuloplasty. LV global longitudinal strain indicators may help to identify LV dysfunction at an early stage, before it happens a significant and irreversible myocardial injury.

References

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery