Yurdakul Selen, Doğan Ali, Aytekin Saide
Department of Cardiology, İstanbul Florence Nightingale Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2017 Jul;45(5):426-433. doi: 10.5543/tkda.2017.92837.
Determining optimal timing for surgery in asymptomatic mitral regurgitation (MR) remains a challenge. The aim of this study was to evaluate subclinical changes in left ventricular (LV) systolic functions using velocity vector imaging (VVI) during follow-up of patients with chronic mitral regurgitation (MR).
A total of 54 patients (mean age: 57.9±8 years; 55% male) with moderate-to-severe MR and normal LV ejection fraction (EF), and 30 healthy controls (mean age: 56±6.5 years; 55% male) were evaluated using conventional echocardiography and VVI at baseline.
At the end of 12 months, measurements of 45 MR patients were repeated. There was no significant change in LV dimensions or EF on follow-up. LV peak systolic strain and strain rate (SR) were decreased in patients with MR compared with controls (strain: 16.29±3.30 to 23.4±1.9; p=0.0001 and SR: 0.93±0.39 to 4.9±0.6; p=0.0001) at baseline. Impairment was more significant on follow-up. (strain: 13.76±2.68 and SR: 0.27±0.14; p=0.0001).
VVI-derived strain imaging might be used in the assessment of subclinical LV dysfunction and its progression during follow-up of patients with chronic MR especially in the decision of optimal timing for surgery.
确定无症状二尖瓣反流（MR）的最佳手术时机仍然是一项挑战。本研究的目的是在慢性二尖瓣反流（MR）患者的随访期间，使用速度向量成像（VVI）评估左心室（LV）收缩功能的亚临床变化。
共有54例中度至重度MR且左心室射血分数（EF）正常的患者（平均年龄：57.9±8岁；55%为男性）以及30名健康对照者（平均年龄：56±6.5岁；55%为男性）在基线时接受了传统超声心动图和VVI检查。
在12个月末，对45例MR患者进行了重复测量。随访期间左心室尺寸或EF无显著变化。与对照组相比，MR患者在基线时左心室收缩期峰值应变和应变率（SR）降低（应变：16.29±3.30至23.4±1.9；p=0.0001；SR：0.93±0.39至4.9±0.6；p=0.0001）。随访时损害更为显著（应变：13.76±2.68；SR：0.27±0.14；p=0.0001）。
VVI衍生的应变成像可用于评估慢性MR患者随访期间的亚临床左心室功能障碍及其进展，特别是在确定最佳手术时机时。
