Evaluation of left ventricular short- and long-axis function in severe mitral regurgitation using 2-dimensional strain echocardiography

Min Seok Kim, Yong Jin Kim, Hyung Kwan Kim, Joo Yong Han, Honggu Chun, Hee Chan Kim, Dae Won Sohn, Byung Hee Oh, Young Bae Park

Research output: Contribution to journalArticle

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Abstract

Background: Few data exist on the changes in left ventricular (LV) short- and long-axis function and their usefulness as markers of LV contractile function in patients with chronic, severe mitral regurgitation (MR). Methods: We studied 59 patients who had severe MR with an ejection fraction ≥50% and 34 healthy controls. Speckle tracking imaging was performed to measure peak systolic radial (SRR), circumferential (SRC), and longitudinal strain rates (SRL). In all patients, the peak rate of LV pressure rise (peak dP/dt) was measured using a micromanometer-tipped catheter. The patients were subdivided into patients with preserved (group 1, peak dP/dt ≥1,300 mm Hg/s [n = 30]) and depressed (group 2 [n = 29]) contractile function. Results: SRL was significantly depressed in groups 1 and 2 when compared with the control group, but there was no difference between groups 1 and 2. In contrast, SRR and SRC were depressed only in group 2, whereas there were no differences between the control group and group 1. SRR and SRC correlated well with peak dP/dt (r = 0.71, P <.001 and r = -0.63, P <.001, respectively), whereas SRL did not. These findings suggest that LV long-axis function becomes depressed earlier than short-axis function in the chronic remodeling process. Conclusions: Left ventricular short-axis function is a useful marker of LV contractility in patients with chronic, severe MR. Left ventricular long-axis function becomes depressed earlier in the chronic remodeling process. Therefore, evaluation of short-axis as well as long-axis function might be important for better assessment of LV contractile function in these patients.

Original languageEnglish
Pages (from-to)345-351
Number of pages7
JournalAmerican Heart Journal
Volume157
Issue number2
DOIs
Publication statusPublished - 2009 Feb 1
Externally publishedYes

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Mitral Valve Insufficiency
Echocardiography
Left Ventricular Function
Control Groups
Ventricular Pressure
Catheters

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Evaluation of left ventricular short- and long-axis function in severe mitral regurgitation using 2-dimensional strain echocardiography. / Kim, Min Seok; Kim, Yong Jin; Kim, Hyung Kwan; Han, Joo Yong; Chun, Honggu; Kim, Hee Chan; Sohn, Dae Won; Oh, Byung Hee; Park, Young Bae.

In: American Heart Journal, Vol. 157, No. 2, 01.02.2009, p. 345-351.

Research output: Contribution to journalArticle

Kim, Min Seok ; Kim, Yong Jin ; Kim, Hyung Kwan ; Han, Joo Yong ; Chun, Honggu ; Kim, Hee Chan ; Sohn, Dae Won ; Oh, Byung Hee ; Park, Young Bae. / Evaluation of left ventricular short- and long-axis function in severe mitral regurgitation using 2-dimensional strain echocardiography. In: American Heart Journal. 2009 ; Vol. 157, No. 2. pp. 345-351.
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AU - Chun, Honggu

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AU - Sohn, Dae Won

AU - Oh, Byung Hee

AU - Park, Young Bae

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N2 - Background: Few data exist on the changes in left ventricular (LV) short- and long-axis function and their usefulness as markers of LV contractile function in patients with chronic, severe mitral regurgitation (MR). Methods: We studied 59 patients who had severe MR with an ejection fraction ≥50% and 34 healthy controls. Speckle tracking imaging was performed to measure peak systolic radial (SRR), circumferential (SRC), and longitudinal strain rates (SRL). In all patients, the peak rate of LV pressure rise (peak dP/dt) was measured using a micromanometer-tipped catheter. The patients were subdivided into patients with preserved (group 1, peak dP/dt ≥1,300 mm Hg/s [n = 30]) and depressed (group 2 [n = 29]) contractile function. Results: SRL was significantly depressed in groups 1 and 2 when compared with the control group, but there was no difference between groups 1 and 2. In contrast, SRR and SRC were depressed only in group 2, whereas there were no differences between the control group and group 1. SRR and SRC correlated well with peak dP/dt (r = 0.71, P <.001 and r = -0.63, P <.001, respectively), whereas SRL did not. These findings suggest that LV long-axis function becomes depressed earlier than short-axis function in the chronic remodeling process. Conclusions: Left ventricular short-axis function is a useful marker of LV contractility in patients with chronic, severe MR. Left ventricular long-axis function becomes depressed earlier in the chronic remodeling process. Therefore, evaluation of short-axis as well as long-axis function might be important for better assessment of LV contractile function in these patients.

AB - Background: Few data exist on the changes in left ventricular (LV) short- and long-axis function and their usefulness as markers of LV contractile function in patients with chronic, severe mitral regurgitation (MR). Methods: We studied 59 patients who had severe MR with an ejection fraction ≥50% and 34 healthy controls. Speckle tracking imaging was performed to measure peak systolic radial (SRR), circumferential (SRC), and longitudinal strain rates (SRL). In all patients, the peak rate of LV pressure rise (peak dP/dt) was measured using a micromanometer-tipped catheter. The patients were subdivided into patients with preserved (group 1, peak dP/dt ≥1,300 mm Hg/s [n = 30]) and depressed (group 2 [n = 29]) contractile function. Results: SRL was significantly depressed in groups 1 and 2 when compared with the control group, but there was no difference between groups 1 and 2. In contrast, SRR and SRC were depressed only in group 2, whereas there were no differences between the control group and group 1. SRR and SRC correlated well with peak dP/dt (r = 0.71, P <.001 and r = -0.63, P <.001, respectively), whereas SRL did not. These findings suggest that LV long-axis function becomes depressed earlier than short-axis function in the chronic remodeling process. Conclusions: Left ventricular short-axis function is a useful marker of LV contractility in patients with chronic, severe MR. Left ventricular long-axis function becomes depressed earlier in the chronic remodeling process. Therefore, evaluation of short-axis as well as long-axis function might be important for better assessment of LV contractile function in these patients.

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