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Assessment of left ventricular function by Doppler Velocity Tissue Imaging of the mitral annulus in patients with mitral stenosis before and after Percutaneous Transvenous Mitral Commissurotomy.


Romeo J. Santos,
Raul D. Jara

Related Institution

Division of Adult Cardiology - Philippine Heart Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Heart Center Journal
Publication Date
April-December 2007


Background: Several methods of assessing the post-PTMC cross-sectional area of the mitral valve by echocardiography in patients with rheumatic mitral stenosis are limited by several factors. Tissue Doppler imaging, a new echocardiographic technique that is being used for to evaluate LV function, eliminates some of the limitations that are encountered with the conventional methods. This study is aimed to determine if there is significant improvement in the mitral annular peak velocity after PTMC and if the change(s) is/are correlated with the planimeterized mitral valve area (MVA).

Methods: Patients with mitral stenosis (MS) in Sinus Rhythm who underwent PTMC from June 01, 2006 to January 15, 2007 were included in the study. Transthoracic Echocardiogram (TIE) and Transesophageal Echocardiogram (TEE) were performed within 24 hours before PTMC. Repeat TTE were performed within 48 hours after the procedure. Tissue Doppler velocities were taken from the lateral and septal annuli during ejection, early diastole and late diastole. Changes between the pre-PTMC values and post- PTMC values were then correlated.

Results: A total of 14 patients who underwent PTMC were included in the study. There is attenuation of all the echocardiographic parameters after PTMC. Among the annular velocities measured, significant improvement is observed only in lateral Sm and Em post PTMC, (p-value 0.011, 0.025). Also, no significant correlation was noted between pre and post PTMC annular velocities with MVA by planimetry, (ejection: r=.30; p=0.285; early diastole: r= 0.28; p=0.329).

Conclusion: There is a significant improvement in lateral Sm and Em post PTMC. There is a trend towards good correlation between the noted improvement in the peak velocities and the change in mitral valve area MVA) by planimetry.


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Philippine Heart Center Medical Library Fulltext Print Format

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