Correlation Analysis Of Left Ventricular Vortex And Myocardiac Strain In Patients With Rheumatic Mitral Stenosis By VFM And STI

Aim:1. To quantitative evaluation of left ventricular vortex by VFM in the patients withrheumatic mitral stenosis and analysis of the effects of the flexilibity of mitralvalve on the votex.2. To explore the effects of the left ventricular vortex on the regional myocardialfunction, STI was used to quantitatively assess myocardiac strain and strain rate.Methods:1. Subjects: In a controlled prospective clinical study,65patients with rheumaticmitral stenosis and35healthy volunteers were enrolled in the study.2. Equipments: Using Aloka α10ultrasonic diagnosis system with DSA-RSI dataanalysis software and GE Vivid7Demision ultrasound system with Echo PACwork station.3. Measurement: All the subjects underwent conventional echocardiography and theassessment of the left ventricular vortex and regional myocardiac function byVFM and STI, sequentially in the same examination. The entire study wasprospectively carried out.Results:1. The Itotal gradually increased in the diastolic and isovolumic contraction from thecontrol to the mild and moderate groups (P<0.05). There was no statisticallysignificant difference between sever and moderate groups in terms of diastole(P>0.05), and the Itotal of the severe group decreased compared to the moderategroup in terms of the isovolumic contraction (P<0.05).2. The Imean gradually increased during the diastolic from the control to the mildand moderate groups, while the Imean of the severe group decreased compared to the moderate group (P<0.05). The Imean of the severe group during theisovolumic contraction decreased compared to the moderate group (P<0.05).3. Compared with the control group, the strain and strain rate of the basal segment ofdifferent left ventricular walls decreased (P<0.05), which was not a statisticallysignificant different between the severe and moderate groups (P>0.05).4. The Itotal was negatively correlated with the mean peak strain and strain rate(r=-0.637to-0.828, P<0.001).5. The CE was negatively correlated with the Imean in the diastolic (r=-0.767,P<0.001), and it was not correlated with the Imean in terms of the isovolumiccontraction (P>0.05).6. Qtotal and Imean measurement demonstrated good reproducibility (intra-ICCs0.830~0.916；inter-ICCs0.820~0.894).Conclusions:1. Despite all the possible variations in estimating vortexes, the present studyshowed that VFM could be used to evaluate the left ventricle vortex withreasonable accuracy in patients with rheumatic mitral stenosis, which mightprovide new insights into the myocardial function in the abnormal hemodynamicconditions.2. It was confirmed that the change of the hemodynamics was closely related to theregional myocardial function. This finding had an important clinicla significancefor the early intervention and the treatment of the patients with mild to moderatemitral stenosis.