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The Journal of Cardiovascular Surgery 2010 April;51(2):277-81

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

The effects of load on systolic mitral annulus movements by tissue Doppler imaging in cardiac surgery patients

Meco M. 1, Cirri S. 2, 3

1 Thoracic Surgery and Anesthesia and Intensive Care Department, Sant’Ambrogio Clinical Institute, Milan, Italy; 2 Anesthesia and Intensive Care Department, Sant’Ambrogio Clinical Institute, Milan, Italy; 3 San Donato Policlinic, San Donato Milanese, Milan, Italy


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AIM: The main indexes of ventricular function used in clinical practice are strongly influenced by the ventricular load conditions. Tissue Doppler imaging (TDI) has been reported to be a powerful modality that enables assessment of ventricular wall motion with a high temporal and spatial resolution. The study of the systolic movements of the mitral annulus has been proposed as a valid index of myocardial contractility. The aim of this study was to verify if the systolic movements of the mitral annulus by TDI are load-dependent in patients undergoing coronary artery bypass grafting. We evaluated the effect of load changes on systolic (SM) and isovolumic (SIVC) velocity waves, and on isovolumic acceleration (SIVA).
METHODS:. Twenty-three patients undergoing coronary artery bypass grafting were evaluate. Load was changed with a rapid infusion of 7 cc/kg of a gelatin solution. The sample volume of TDI was placed at the lateral side of the mitral annulus in the mid-esophageal 4-chamber view.
RESULTS:. The increase preload resulted in a statistically significant increase of SM (8.7±1.04 cm/s vs. 9.99±0.88 cm/s P=0.01), and a statistically significant increase of SIVC (5.65±1.95 cm/s vs. 6.75±1.53 cm/s P=0.03).
SIVA does not appear to be changed after the increase of preload (203.45±45.69 cm/s2 vs. 211.41±71.28 p=0.81).
CONCLUSION:Only SIVA seems to be an independent index of cardiac functionality in cardiac surgery patients and appears to be an optimum index in the clinical evaluation of these patients.

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massimo.meco@virgilio.it