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Romatizmal Hafif Mitral Kapak Tutulumunda Sağ Ventrikül Fonksiyonlarının Doku Doppler Ekokardiyografi ile Değerlendirilmesi

Assessment of Right Ventricular Function in Patients with Rheumatic Mild Mitral Involvement by Tissue Doppler Echocardiography

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2012
DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.69875

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: There is no data related to right ventricular func-tions in mild mitral stenosis patients with normal pulmonary pressure. Therefore, in the present study we investigated right ventricular functions in mild mitral stenosis patients who had visually normal right ventricul by tissue Doppler imaging. Methods: The study population consisted of 42 rheumatic mild mitral stenosis patients and 31 age-sex matched con-trols. All patients underwent conventional echocardiography and tissue Doppler imaging. Isovolumetric myocardial accel-eration, myocardial performance index and peak systolic velocities were calculated from the tissue Doppler parame-ters. Results: The study groups were comparable regarding age, sex, systolic pulmonary artery pressure, systolic-diastolic blood pressure and heart rate. When compared to the con-trol group patients with mitral stenosis had significantly lower values of isovolumetric myocardial acceleration (p: 0,001), myocardial performance index (p: 0,014) and peak systolic velocity (p: 0,001). Within the tissue Doppler param-eters, isovolumetric myocardial acceleration was the most closely correlated parameter with the mitral valve area (r: 0.59; p: 0,0001). Conclusion: Rheumatic mild mitral stenosis patients with visually normal right ventricle had impaired right ventricular function assessed by tissue Doppler imaging. This impaired function might be related to the rheumatismal myocardial involvement rather than abnormalities in the pulmonary vasculatories.
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Abstract (Original Language): 
Amaç: Romatiznal hafif mitral darlıklı hastalarda, pulmoner arter basıncı normalken sağ ventrikül fonksiyonları ile ilgili veri yoktur. Biz bu çalışmamızda görsel ve boyutsal olarak normal sağ ventriküle sahip hafif mitral darlığı hastalarında sağ ventrikül fonksiyonlarını doku Doppler ile değerlendir-meyi planladık. Yöntemler: Çalışmaya 42 romatizmal hafif mitral darlıklı hasta ve 31 yaş ve cinsiyet eşleşmiş kontrol grubu alındı. Hastalara konvensiyonel ve doku Doppler ekokrdiyografi yapıldı. Doku Doppler parametlerinden izovolümetrik miyo-kardiyal akselarasyon, miyokard performans indeksi ve tepe sistolik velosite hesaplandı. Bulgular: Her iki grupta yaş ortalaması, cinsiyet, sistolik pulmoner arter basıcı sistolik ve diyastolik kan basıncı ve kalp hızı değerleri benzerdi. Doku Doppler parametrelerin-den izovolümetrik miyokardiyal akselarasyon (p: 0,001), miyokard performans indeksi (p: 0,014) ve tepe sistolik velosite (p: 0,001) anlamlı olarak hasta grubunda düşük saptandı. İzovolümetrik miyokardiyal akselarasyon doku Doppler parametrelerinden arasında mitral kapak alanı ile en iyi korele olan paramatre olarak bulundu (r: 0.59; p: 0,0001). Sonuç: Görsel ve boyutsal olarak normal sağ ventriküle sahip romatizmal hafif mitral darlığı hastalarında doku Doopler ile değerlendirilen sağ ventrikül fonksiyonları bozulmuştur. Sağ ventrikül fonksiyonlarındaki bu bozukluk pulmoner vasküla-türdeki değişikliklerden çok sağ ventrikülün romatizmal tutulumuna bağlı olabilir.
FULL TEXT (PDF): 
PDF icon arastirmax-romatizmal-hafif-mitral-kapak-tutulumunda-sag-ventrikul-fonksiyonlarinin-doku-doppler-ekokardiyografi-ile-degerlendirilmesi.pdf
  • 3
149-155
  • Turkish

REFERENCES

References: 

1. Rahimtoola SH, Durairaj A, Mehra A, Nuno I. Current evaluation and management of patients with mitral stenosis. Circulation 2002;106:1183.
2. Arslan S, Buyukkaya S, Gundogdu F, Sevimli S, Buyuk-kaya E, Aksakal E, Karekelloglu Ş. Assessment of right ventricular functions by tissue Doppler echocardiog-raphy in patients with rheumatic mitral valve stenosis associated with sinus rhythm or atrial fibrillation. Turk Kardiyol Dern Arş 2007;35:475-81.
3. Iung B, Gohlke-Bärwolf C, Tornos P, Tribouilloy C, Hall R, Butchart E, Vahanian A; Working Group on Valvular Heart Disease. Recommendation on the management of the asymptomatic patient with valvular heart dis-ease. Eur Heart J. 2002;23:1253-66
4. Otto CM: Mitral stenosis. In Otto CM (ed): Valvular Heart Disease. 2nd ed Philadelphia, WB Saunders, 2004, pp 252–255
5. Hirata N, Sakakibara T, Shimazaki Y, Watanabe S, Nomura F, Akamatsu H, Sasaki J, Kodama K, Nakano S,
Kawashima Y. Preoperative and postoperative right ventricular function during exercise in patients with mitral stenosis. J Thorac Cardiovasc Surg 1992;104:1029-34.
6. Burger W, Brinkies C, Illert S, Teupe C, Kneissl GD, Schrader R. Right ventricular function before and af-ter percutaneous balloon mitral valvuloplasty. Int J Cardiol 1997;58:7-15.
7. Nagel E, Stuber M, Hess OM. Importance of the right ventricle in valvular heart disease. Eur Heart J 1996;17:829-36
8. Diwan A, McCulloch M, Lawrie GM, Reardon MJ, Nagueh SF. Doppler estimation of left ventricular fill-ing pressures in patients with mitral valve disease. Circulation 2005;111:3281-9.
9. Ozdemir K, Altunkeser BB, Gok H, Icli A, Temizhan A. Analysis of the myocardial velocities in patients with mitral stenosis. J Am Soc Echocardiogr 2002;15:1472-8.
1. Rahimtoola SH, Durairaj A, Mehra A, Nuno I. Current evaluation and management of patients with mitral stenosis. Circulation 2002;106:1183.
2. Arslan S, Buyukkaya S, Gundogdu F, Sevimli S, Buyuk-kaya E, Aksakal E, Karekelloglu Ş. Assessment of right ventricular functions by tissue Doppler echocardiog-raphy in patients with rheumatic mitral valve stenosis associated with sinus rhythm or atrial fibrillation. Turk Kardiyol Dern Arş 2007;35:475-81.
3. Iung B, Gohlke-Bärwolf C, Tornos P, Tribouilloy C, Hall R, Butchart E, Vahanian A; Working Group on Valvular Heart Disease. Recommendation on the management of the asymptomatic patient with valvular heart dis-ease. Eur Heart J. 2002;23:1253-66
4. Otto CM: Mitral stenosis. In Otto CM (ed): Valvular Heart Disease. 2nd ed Philadelphia, WB Saunders, 2004, pp 252–255
5. Hirata N, Sakakibara T, Shimazaki Y, Watanabe S, Nomura F, Akamatsu H, Sasaki J, Kodama K, Nakano S,
Kawashima Y. Preoperative and postoperative right ventricular function during exercise in patients with mitral stenosis. J Thorac Cardiovasc Surg 1992;104:1029-34.
6. Burger W, Brinkies C, Illert S, Teupe C, Kneissl GD, Schrader R. Right ventricular function before and af-ter percutaneous balloon mitral valvuloplasty. Int J Cardiol 1997;58:7-15.
7. Nagel E, Stuber M, Hess OM. Importance of the right ventricle in valvular heart disease. Eur Heart J 1996;17:829-36
8. Diwan A, McCulloch M, Lawrie GM, Reardon MJ, Nagueh SF. Doppler estimation of left ventricular fill-ing pressures in patients with mitral valve disease. Circulation 2005;111:3281-9.
9. Ozdemir K, Altunkeser BB, Gok H, Icli A, Temizhan A. Analysis of the myocardial velocities in patients with mitral stenosis. J Am Soc Echocardiogr 2002;15:1472-8.

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