Abstract 3383: Assessment Of The Left Ventricular Long-axis And Short-axis Function Using Strain Rate Imaging In Chronic Severe Mitral Regurgitation: A Comparative Echocardiography-catheterization Study
Background Assessment of the left ventricular (LV) contractile function is critical for deciding optimal timing of surgery in patients with chronic severe mitral regurgitation (MR). We investigated the LV long-axis and short-axis function in MR.
Methods We studied 30 patients (16 men, age: 51 ± 14 years) who had 3+ or 4+ MR with LV ejection fraction (EF) greater than 50%. Comprehensive 2D and Doppler echocardiography was performed. Peak systolic radial (SRR), circumferential (SRC), and longitudinal strain rate (SRL) were measured using speckle tracking imaging. In all patients, peak dP/dt was measured using micromanometer-tipped catheter.
Results Mean LVEF was 63.1% and regurgitation fraction was 61.8%. LV end-systolic volume was 78.3 ml. Peak dP/dt ranged from 1019 to 2049 mmHg/sec with the mean value of 1583 mmHg/sec. 16 patients (53.3%) showed latent systolic dysfunction defined by peak dP/dt less than 1300 mmHg/s. SRR and SRC correlated well with peak dP/dt (Fig. A⇓, r=0.74, p< 0.01, r=− 0.54, p<0.01, respectively). However, SRL did not correlate with peak dP/dt (r=− 0.58, p=0.76). SRR > 1.94 S−1 showed a sensitivity of 86 % and a specificity of 75 % for predicting latent LV systolic function (Fig. B⇓, AUC=0.87, CI=0.732– 0.991). SRR also correlated with LV end-diastolic and end-systolic sphericity index (r=− 0.54, p<0.01, r=− 0.66, p< 0.01, respectively).
Conclusion SRR and SRC, not SRL, correlated well with peak LV dP/dt. These results imply the importance of short-axis function in the presence of chronic severe MR, probably due to the geometrical change in response to chronic volume overload.