Evaluation of Left Ventricular Function by Conventional Echocardiography and Tissue Doppler Imaging in Patients with Acute and Chronic Mitral Regurgitation

Left ventricular function is affected differently in acute and chronic mitral regurgitation (MR). Twenty-six patients (12 men and 14 women, average age: 55±20 years) with acute severe MR caused by flail leaflet and 30 patients with chronic severe MR of organic origin (14 men and 16 women, average age: 56±14 years) were included in the study. All of the patients were evaluated in detail by conventional echocardiography and tissue Doppler imaging (TDI). Among conventional echocardiographic parameters, left ventricle ejection fraction (%) was found higher in acute MR (71±5/59±12, p=0.001) whereas left ventricle end-systolic volume, left ventricle end-diastolic volume, left ventricle end-systolic diameter, left ventricle end-diastolic diameter, left atrium dimension, and left atrial area were significantly higher in chronic MR. Among TDI parameters, peak systolic wave velocities (11.4±3.6/8.8±2.5cm/s, p=0.018), peak early diastolic velocities (10.8±4.5/9.3±3.8cm, p=0.03), and contraction time (248±56/219±47ms, p=0.04) were found higher in acute MR, whereas precontraction time (119±29/164±48ms, p=0.005) and precontraction time to contraction time ratio (0.52±0.23/0.78±0.28, p=0.008) were significantly higher in chronic MR. As evaluated by conventional echocardiography, the systolic function of chronic MR was also normal, although it was lower than that of acute MR. We also found that left ventricular systolic and diastolic functions by TDI were also relatively preserved in patients with acute MR when compared with those with chronic MR.

Key words: echocardiography, flail mitral valve, left ventricle function, mitral regurgitation, tissue Doppler imaging