Systolic Mitral Annular Velocity as a Simple Marker of Left Ventricular Peak Systolic dP/dt in Patients with Significant Mitral Regurgitation

Introduction Evaluating the left ventricular (LV) contractile function in patients with severe mitral regurgitation (MR) is a difficult clinical problem. Because of the favorable loading condition, ejection phase indexes such as ejection fraction (EF) may remain in the normal range despite the presence of significant contractile dysfunction and mislead the decisions regarding the indications and timing of surgery. Among many parameters proposed as a measure of myocardial function, Doppler-derived rate of LV pressure rise during ventricular contraction (dP/dtDoppler) has been shown to correlate well with peak dP/dt measured by cardiac catheterization and thus postoperative LV function. However, it is limited clinically due to the complexity of the measurements and the difficulty in obtaining appropriate Doppler tracing in patients with eccentric MR. Doppler tissue imaging (DTI) is a relatively new ultrasound algorithm that records systolic and diastolic velocities within the myocardium. The velocity of annular