Assessment of Regional Left Atrial Deformation Properties at the Left Atrial Free Lateral Wall by Tissue Doppler Imaging in Mitral Valve Disease

Abstract

Rheumatic heart disease is a main health problem, this work was done to study the deformation occurs in the left atrium free lateral wall in the rheumatic mitral valve diseased patients and its effect on the haemodynamic function of the left atrium (LA) which primarily modulates the left ventricular (LV) filling through its three components: a reservoir component during ventricular systole, a conduit component during early ventricular diastole, and a booster pump component during late ventricular diastole. The LA function was assessed non-invasively by tissue Doppler imaging (TDI). Sixty individuals were include in our study thirty of them were mitral valve diseased patients (20 pure mitral regurgitation and 10 pure mitral stenosis) and the other thirty were normal healthy volunteers. We excluded any patient hypertension, diabetes, ischemic heart disease, atrial fibrillation and heart failure. All patients were assessed by: - 2D echocardiography for the mitral valve area assessment by planimetry. - M-mode for left ventricular dimensions and Simpson’s method to detect ejection fraction. - Pulsed Doppler echocardiography for the measurement of: (E-wave, A-wave, deceleration time and isovolumetric relaxation time). - Tissue Doppler imaging for the assessment of S′, E′ and A′ waves. The main result was that the value of waves measured by tissue Doppler imaging S′, E′ and A′ waves were Summary -140- significantly decreased in mitral valve diseased patients when compared to normal individuals and our study proved that that affection was not related to the severity of mitral valve disease either stenosis or regurgitation but it is mostly due to the inflammatory response of rheumatic fever.