The use of two-dimensional and Doppler echocardiography in assessing mitral regurgitation and segmental contractility disturbances in patients with dilated cardiomyopathy and ischaemic heart disease.

Forty-three patients with dilated cardiomyopathy (DCMP) and 12 patients with ischaemic heart disease (HD) in different stages of heart failure were examined using ultrasound sector scanning and pulsed Doppler echocardiography. The degree of mitral regurgitation was determined semi-quantitatively, according to the distance at which the turbulent blood stream penetrates into the left atrial cavity. The dimensions of the left atrium and auscultatory manifestations are not always a reliable indicator of the degree of regurgitation. The severity of mitral regurgitation depends on the dilatation and reduced contractility of the left ventricle as well as on the dilatation of the mitral annulus. Segmental contractility of the left ventricle was assessed using computer analysis of two-dimensional EchoCG. A characteristic feature of DCMP is not only a diffuse decrease in left ventricular contractility but also its segmental disturbances. These disturbances are in DCMP the same as in IHD, but in patients with DCMP there is no simultaneous occurrence of normokinetic and dyskinetic segments.