ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH MODERATE ISCHEMIC MITRAL INSUFFICIENCY BEFORE AND AFTER SURGICAL REVASCULARIZATION AND MITRAL ANNULOPLASTY

Aim. To perform the echocardiographic assessment of the diastolic function of the left ventricle in patients with moderate ischemic mitral insufficiency (IMI) before and after surgical revascularization and mitral annuloplasty. Materials and methods. The study included 48 patients aged 39 to 78 years (mean age 58,4 ± 10,5 years); there were 39 (81,2 %) men with multivascular lesion of the coronary arteries and IMI (flow area index 26,06 ± 6,4 % to left atrium area, vena contacta width 4,8 ± 0,86 mm). In the study group, there predominated patients with functional class III exertional angina (39 patients - 81,2 %) and functional class II heart failure (39 patients - 81,2 %) (CH, NYHA). The preoperative LVFF values were on average 40,4 ± 7,3 %, end-systolic volume 91,3 ± 26,3 ml, end-diastolic volume 152 ± 29,9 ml. Results. In the postoperative period, no patients with normal diastolic function or with disturbed relaxation were detected. Taking into account both transmitral blood flow and tissue Doppler, only pseudonormal and restrictive types of diastolic dysfunction (DD) were revealed, but with regard to tissue Doppler data, more often restrictive DD was found (total 42 patients, 87,5 %), whereas before the surgery, no patients with restrictive DD were revealed. Conclusions. Among patients with moderate ischemic mitral insufficiency in the preoperative period there predominates the pseudonormal type of diastolic dysfunction, but after mitral annuloplasty - restrictive one.

Ischemic mitral insufficiency, mitral annuloplasty, diastolic function of left ventricle