Iqbal Muhammad Khaleel, Maqbool Muhammad Furrakh, Tawwab Shahzad, Awan Muhammad Saleem, Naveed Tahir, Butt Usman Mahmood
Department of Cardiology, Allama Iqbal Medical College/ Jinnah Hospital, Lahore.
D.G. Khan Medical College, D.G. Khan.
J Ayub Med Coll Abbottabad. 2020 Apr-Jun;32(2):169-173.
In rheumatic severe mitral regurgitation, earlier detection of left ventricular dysfunction is very necessary in order to refer the patients for surgery at appropriate time. This study tried to find a correlation between conventional parameters of left ventricular dysfunction with systolic strain rate.
A descriptive correlational study conducted from September 2016 to March 2018. One hundred and ninety-two patients of severe rheumatic MR and fifty-eight healthy controls were included. Left ventricular ejection fraction (LVEF), end diastolic dimension (LVEDD) and end systolic dimension (LVESD) were measured. Healthy controls were taken as group-I and patients were divided into group-II (ejection fraction ≥60% and LVESD ≤40 mm), group-III (ejection fraction ≥60% and LVESD ≤41-50 mm), and group-IV (ejection fraction <60%). Systolic strain rate at medial wall (SSR-med), at lateral wall (SSR-lat) and average of both (SSR-avg) were also measured by tissue doppler method for each study subject.
Out of 250 study subjects, males were 113 (45.2%) and females were 137 (54.8%). Means of the age, LVEF, LVEDD and LVESD were 30.8±9.1, 60.0±8.3, 58.5±7.8 and 37.4±9.9 respectively. Group I, II, III and IV contained 58, 69, 67 and 56 subjects respectively. Comparing these groups, mean LVEF progressively decreased from 63.9%±2.2 in group-I to 46.2±6.5 in group-IV while means of LVEDD and LVESD progressively increased from 45.9±3.5 and 23.2±2.3 in group-I to 64.3±3.6 and 49.0±2.9 in group-IV respectively. Average systolic strain rate (SSR-avg) decreased progressively from 1.57±0.06 in group-I to 0.83±0.08 in group-IV. All the strain rates, i.e., SSRmed, SSR-lat and SSR-avg showed significant negative correlation with left ventricular dysfunction, i.e., the group number (p<0.001).
Systolic strain rate measured by tissue doppler method have significant negative correlation with left ventricular dysfunction in patients having rheumatic chronic severe mitral regurgitation.
在风湿性重度二尖瓣反流中，早期发现左心室功能障碍对于在适当时间将患者转诊进行手术非常必要。本研究试图找出左心室功能障碍的传统参数与收缩期应变率之间的相关性。
2016年9月至2018年3月进行了一项描述性相关性研究。纳入192例重度风湿性二尖瓣反流患者和58例健康对照者。测量左心室射血分数（LVEF）、舒张末期内径（LVEDD）和收缩末期内径（LVESD）。将健康对照者作为第一组，患者分为第二组（射血分数≥60%且LVESD≤40mm）、第三组（射血分数≥60%且LVESD为41 - 50mm）和第四组（射血分数<60%）。还通过组织多普勒方法测量了每个研究对象的室间隔壁收缩期应变率（SSR-med）、侧壁收缩期应变率（SSR-lat）以及两者的平均值（SSR-avg）。
在250名研究对象中，男性113名（45.2%），女性137名（54.8%）。年龄、LVEF、LVEDD和LVESD的平均值分别为30.8±9.1、60.0±8.3、58.5±7.8和37.4±9.9。第一组、第二组、第三组和第四组分别包含58名、69名、67名和56名受试者。比较这些组，平均LVEF从第一组的63.9%±2.2逐渐降至第四组的46.2±6.5，而LVEDD和LVESD的平均值则分别从第一组的45.9±3.5和23.2±2.3逐渐增至第四组的64.3±3.6和49.0±2.9。平均收缩期应变率（SSR-avg）从第一组的1.57±0.06逐渐降至第四组的0.83±0.08。所有应变率，即SSR-med、SSR-lat和SSR-avg与左心室功能障碍（即组别）均呈显著负相关（p<0.001）。
组织多普勒方法测量的收缩期应变率与风湿性慢性重度二尖瓣反流患者的左心室功能障碍呈显著负相关。
