Erturk Mehmet, Aksu Hale Unal, Celik Omer, Uzun Fatih, Akgul Ozgur, Pusuroglu Hamdi, Kalkan Ali Kemal, Yalcin Ahmet Arif, Satilmisoglu Muhammet Hulusi, Erol Mustafa Kemal
Department of Cardiology, Istanbul Mehmet Akif Er soy Thoracic and Car diovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Cardiol J. 2014;21(4):442-8. doi: 10.5603/CJ.a2013.0114. Epub 2013 Aug 30.
Isovolumic acceleration (IVA) is a new tissue Doppler parameter in the assessment of systolic function of both left and right ventricles. It remains unaffected with the changes in pre- and after-load within the physiological range. The aim of our study was to assess the effect of mitral stenosis degree, which is determined by echocardiography, on the left ventricular (LV) function using IVA.
A total number of 62 patients with mitral stenosis (MS) and 32 healthy controls were examined. The severity of MS (mild, moderate, and severe) was determined on the basis of mitral valve area (MVA) and the mean diastolic mitral gradient findings. The peak myocardial velocities during isovolumic contraction, systole, early diastole and late diastole were measured by using tissue Doppler imaging (TDI).
All TDI-derived global LV basal wall systolic (peak myocardial isovolumic contraction velocity, peak myocardial systolic velocity and IVA), and diastolic velocities (peak early and late diastolic velocities) were significantly decreased in the patients with MS, compared to the healthy patients (p < 0.001, for all). However, IVA was not different when the degree of MS was evaluated (p = 0.114). In addition, IVA was not correlated with the MVA (r = 0.185, p = 0.150).
Left ventricular function is impaired in patients with MS regardless of the severity of the disease.
等容加速（IVA）是评估左、右心室收缩功能的一项新的组织多普勒参数。在生理范围内，它不受前负荷和后负荷变化的影响。我们研究的目的是使用IVA评估经超声心动图测定的二尖瓣狭窄程度对左心室（LV）功能的影响。
共检查了62例二尖瓣狭窄（MS）患者和32例健康对照者。根据二尖瓣瓣口面积（MVA）和平均舒张期二尖瓣压差结果确定MS的严重程度（轻度、中度和重度）。使用组织多普勒成像（TDI）测量等容收缩期、收缩期、舒张早期和舒张晚期的心肌峰值速度。
与健康患者相比，MS患者所有TDI衍生的左心室基底壁整体收缩期（心肌等容收缩期峰值速度、心肌收缩期峰值速度和IVA）及舒张期速度（舒张早期和晚期峰值速度）均显著降低（所有p<0.001）。然而，评估MS程度时，IVA无差异（p = 0.114）。此外，IVA与MVA无相关性（r = 0.185，p = 0.150）。
无论疾病严重程度如何，MS患者的左心室功能均受损。
