Kenan DEMİR, Mehmet Sıddık ÜLGEN, Fatih KOC, İlknur CAN, Mehmet YAZICI, Mehmet Akif VATANKULU

Isolated mitral valve prolapsus does not affect left ventricular function ınsights from tissue-doppler echocardiography

Amaç: İdiopatik Mitral Kapak Prolapsusu (MVP), mitral kapağın miksomatöz dejenerasyonuyla karakterizedir. MVPli hastalarda kardiyovasküler mortalitenin en önemli belirleyicisi Sol Ventrikül (LV) disfonksiyonudur. Bu yüzden biz izole MVP hastalarında doku doppler ekokardiyografi (TDE) ile LV fonksiyonunu değerlendirmeyi amaçladık. Metod: MVPli 25 hasta (ortalama yaş, 31±12) çalışmaya MVP grubu olarak dahil edildi. Kontrol grubu ise yaş ve cinsiyet eşleştirilmiş 20 hastadan oluşturuldu (ortalama yaş, 34±9). LV fonksiyonları konvansiyonel ekokardiyografi ve TDE ile incelendi. Miyokardiyal zirve sistolik (Sm), erken (Em) ve geç (Am) diastolik dolum hızları, Em/Am, isovolumetrik kontraksiyon zamanı (ICT), isovolu- metrik relaksasyon zamanı (IRT) ve ejeksiyon zamanı (ET) ölçümleri inferior-septal ve lateral duvarın bazal segmentlerinden ölçüldü. Miyokardial performans indeksi (MPI) hesaplandı. Bulgular: MVPli hastaların 10unda (%40) hafif derecede mitral yetmezlik, 2sinde (%8) orta derecede mitral yetmezlik vardı. Diastolik parametreler açısından 2 grup arasında fark bulunamadı. TDEden hesaplanan MPI değerleri iki grupta tüm segmentlerde benzerdi. Sol ventrikül ortalama Sm ve lateral duvar Smde iki grup arasında anlamlı fark vardı (11.6±2.8 vs. 9.4±1.0, p=0.001; 13.0±3.9 vs. 9.2±2.3, p=0.001 sırasıyla). Sonuç: Belirgin mitral yetmezliği olmayan izole MVP sol ventrikül diastolik fonksiyonunu ve MPIyi etkilemez. Fakat, MVPli hastaların lateral duvar Sm ve LV ortalama Smsi MVPsi olmayanlara göre daha yüksekti.

İzole mitral kapak prolapsusu sol ventrikül fonksiyonunu etkilemez

Aim: Idiopathic mitral valve prolapsus (MVP) is characterized by myx- omatous degeneration of mitral valve. The most common determinant of cardiovascular mortality in patients with MVP is left ventricular (LV) dysfunction. Therefore we aimed to evaluate LV functions of cas- es with isolated MVP by tissue Doppler echocardiography (TDE). Method: Twenty five patients with MVP (mean age, 31±12 years) were enrolled the study as MVP group. Control group was consisted 20 age and sex matched patients (mean age, 34±9 years) were enrolled to this study. LV functions were detected by using conventional echocar- diography and TDE. Myocardial peak systolic (Sm), early (Em) and late (Am) diastolic filling velocities, Em/Am, isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT) and ejection time (ET) were obtained in the basal segments of the inferior-septal and lateral wall. Myocardial performance index (MPI) was calculated. Result: Mild degree mitral regurgitation was present in 10 (40%) of patients with MVP, and moderate degree mitral regurgitation was present in 2 (8%) of patients. No difference was found between the two groups with regard to diastolic parameters. TDE-derivated MPI values were similar in all segments in two groups. There was sig- nificant difference between the two groups with regard to LV mean Sm and lateral wall Sm (11.6±2.8 vs. 9.4±1.0, p=0.001; 13.0±3.9 vs. 9.2±2.3, p=0.001 respectively). Conclusion: Isolated MVP without significant mitral regurgitation does not affect LV diastolic functions and MPI. However, Sm of late ral wall and LV mean was higher in patients with MVP than patients without MVP.

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