Mitral Annulus and Left Ventricular Posterior Wall Motion in Mitral Valve Replaced Patients

Park, Chong Hun; Lee, Young

Abstract

To assess the effects of regional wall motion abnormalities on left ventricular function, mitral annulus(MA) motion and left ventricular posteior wall(LVPW) motion were studied by M-mode and Doppler echocardiography in 13 normal subjects and 40 mitral valve replaced(MVR) patients. In MVR patients, mitral annulus motion showed significantly delayed contraction(DC) after A2 by 3.7+/-3.0mm in amplitude and 80+/-35 msec in time(normal control; 0.1+/-0.3mm, 35+/-15msec, p<0.01 for both) and reduction in systolic % thickening of LVPW(39.7+/-23.6 VS 63.2+/-18.4%, p<0.01). MVR patients were devied into 2 group according to the amplitude of MA motion, 4mm Group I(n=13, DC> or =4mm) showed increase epicardial excursion of LVPW compared with Group II(n=27, DC<4mm)(Group I vs Group II, 11+/-3.7 vs 8.6+/-2.6 mm, p<0.05). In mechanical prosthetic valve replaced patients(n=22), time relationship between valve opening, mitral flow, peak thining rate of LVPW and valve peak excursion were studied also and the phase difference that are observed in normal subjects, were lost. We interpreted these delayed contraction of mitral annulus motion and epicardial motion increment as muscle fiber architectural abnormalities which might effect on MVR patients as a factor of left ventricular systolic and diastolic dysfunction.