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F. B. Tournoux, C. Alabiad, D. Fan, A. A. Chen, M. Chaput, K. Heist, T. Mela, M. Mansour, V. Reddy, J. N. Ruskin, M. H. Picard and J. P. Singh, “Echocardiographic Measures of Acute Haemodynamic Response after Cardiac Resynchronization Therapy Predict Long-Term Clinical Outcome,” European Heart Journal, Vol. 28, No. 9, 2007, pp. 1143-1148. doi:10.1093/eurheartj/ehm050

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• TITLE: How to Identify Latent Systolic Dysfunction and Post Operative Risk in Patients with Mitral Incompetence and Normal Ejection Fraction?

  AUTHORS: Galal Eldin Nagib Elkilany, Maryam De Groef, Ibrahim Kabbash

  KEYWORDS: Mitral Incompetence, Systolic Dysfunction, MR dp/dt, Global Strain

  JOURNAL NAME: World Journal of Cardiovascular Surgery, Vol.1 No.2, December 27, 2011

  ABSTRACT: Purpose: To study the significance of impaired positive peak rate of left ventricular (LV) pressure development (MR + dp/dt) and global systolic strain (GLPSS) values in patients presented with significant mitral incompetence (MR) in coronary artery disease (CAD) and early dilated cardiomyopathy (DCM) with normal ejection fraction (EF). Methods: A description of LV contractile behavior requires measurement of the ability of the ventricle to develop force (pressure) and to shorten. Hence, performance of the ventricle as a pump assessed in the present study by measuring the pressure developed by the ventricle (Left ventricular +dP/dt is estimated from MR jet as the rate of pressure rise from 1 to 3 m/sec) and shortening assessed by GLPSS (this Doppler technology allowed measurement of LV systolic strain for the entire length of LV myocardium). GLPSS and MR + dp/dt were calculated in 30 consecutive patients (mean age was 55 ± 12 years) characterized by echocardiographic evidence of moderate or severe MR (in CAD and DCM patients) and normal EF (mean LV Ejection Fraction of 50.9% ± 5.9%) and compared with those obtained in 35 consecutive controls (age 54.7 ± 11.4 years) with normal echocardiographic study of the heart. Results: The mean values of MR +dp/dt and GLPSS averaged from the 3 apical views, differed significantly in DCM and CAD patients (characterized by significant MR with normal EF) compared with control group, (MR + dp/dt = 733 ± 170 mmhg/s and GLPSS –13% ± 1.3%) versus (1420 ± 210 mmhg/s and -19.5% ± 3.3%) for patients versus control, respectively, p