Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic valve disease

Evaluation of left ventricular functions by conventional echocardiography and tissue Doppler imaging in children with rheumatic mitral regurgitationRomatizmal mitral yetmezlikli çocuklarda geleneksel ekokardiyografi ve doku Doppler görüntüleme ile sol ventrikül fonksiyonlarının değerlendirilmesi Introduction:We aimed to evaluate left ventricular functions in children with mitral regurgitation (MR) who were followed up with the diagnosis rheumatic carditis, by using conventional echocardiography and tissue Doppler imaging (TDI) and compare the results with those of healthy control subjects.Methods: 30 patients who were followed up with the diagnosis of MR due to sequel of rheumatic carditis in our pediatric cardiology clinic and 30 healthy children aged between 5-15 years were included in the study.The patient group was categorized as mild-moderate MR (n=20), and severe MR (n=10).All echocardiographic and Doppler assessments were performed by a single expert pediatric cardiologist, who was blinded to the clinical and laboratory results of the study group.Results: LV end-diastolic diameters were significantly increased in patient with severe MR compared to controls (4.62±0.82cm,3.92±0.39cm; p=0.008).Also LV end-systolic diameters were found significantly increased in patient with severe MR compared to controls (2.81±0.51,2.43±0.25,p=0.01).There was no statistically significant difference between groups in terms of LV ejection fraction and fractional shortening (p>0.05).Although peak early diastolic myocardial velocity obtained with TDI did not show significantly difference between the groups (p>0.05),peak atrial systolic velocity measured from the lateral and septal annulus were significantly increased in patients with severe MR when compared with controls and patients with mild--modarete MR (p<0.001,p=0.001; respectively). Discussion and Conclusion:In our study, LV systolic and diastolic functions obtained by conventional echocardiographic measurements, showed no significant difference between the controls and patients with MR.However, deterioration in subclinical LV systolic and diastolic function was detected by TDI the patient group with MR.