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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2010 Aprile;51(2):277-81
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
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.