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KMID : 0390620080160020048
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Journal of Cardiovascular Ultrasound
2008 Volume.16 No. 2 p.48 ~ p.53
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Systolic Mitral Annular Velocity as a Simple Marker of Left Ventricular Peak Systolic dP/dt in Patients with Significant Mitral Regurgitation
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Kim Min-Seok
Kim Yong-Jin
Kim Hyung-Kwan
Kwon Dong-A
Kim Dae-Hee
Seo Jae-Bin
Yang Han-Mo
Choi Dong-Hyun
Sohn Dae-Won
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Abstract
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Background: Evaluating left ventricular (LV) contractile function in patients with mitral regurgitation (MR) is a
difficult clinical problem. Although LV dP/dt measured by Doppler echocardiography has been shown to be a good
marker for LV contractility, it is limited clinically due to the complexity of the measurement and the difficulty in obtaining
appropriate Doppler tracings in patients with eccentric MR. We hypothesized that systolic mitral annulus velocity (S’) can
be a good marker of LV dP/dt.
Methods: We studied 62 patients (25 men, age: 47±15 years) who had 3+ or 4+ MR with normal LV systolic function (ejection fraction ＞50%). Two-dimensional and Doppler echocardiography was performed. LV dP/dt-Doppler was
measured using MR jet tracing as previously reported. S’ velocity was measured at the septal annulus using Doppler tissue imaging. In 10 patients undergoing mitral surgery, LV pressure was measured with micromanometer-tipped catheter and peak dP/dt-cath was calculated.
Results: Mean LV ejection fraction was 60±6% and regurgitant fraction was 59±15%. S’ velocity correlated well with LV dP/dt-Doppler (r=0.50, p＜0.01). In 10 patients who underwent LV catheterization, LV dP/dt-Doppler correlated well
with peak dP/dt-cath (r=0.68, p=0.03). Whereas S’ velocity could be measured in all patients, LV dP/dt-Doppler could not
be measured in 31 patients (50%) due to eccentric jet direction.
Conclusion: Systolic mitral annulus velocity is a simple and feasible marker of LV dP/dt and, therefore, may be useful for assessing myocardial contractile function in patients with MR.
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KEYWORD
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Mitral regurgitation, Systolic mitral annulus velocity, dP/dt
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