Assessment the papillary muscle function of functional mitral regurgitation using speckle tracking technology

Abstract

Objective: To evaluate the function of left-side papillary muscles (PM) in ischemic and non-ischemic cardiomyopathy patients (ICM, NICM) with functional mitral regurgitation (FMR). Methods: Eighty control subjects were enrolled (group H). Sixty ICM patients with FMR were enrolled according to coronary angiography. Sixty NICM patients with FMR were enrolled as Contemporary definitions and classification of the cardiomyopathies. All patients were divided into three groups as the degree of FMR, mild FMR is group F1, moderate FMR is group F2, severe FMR is group F3. Standard transthoracic echocardiography were performed. All data were exported to Philips Qlab 8.1 workstation for 2D STI analysis. The parameters include: the longitudinal strain of anterior PM (APM), posterior PM (PPM) (ALS, PLS), the peak time of APM, PPM (APT, PPT), and the delay time of peak value between APM and PPM (DT). Results: The results illustrate ALS and PLS decreased, the APT, PPT, DT increased with increased of FMR degree (F>3.84,p 0.05). In addition, compared with control subjects, there was significant alteration of PM acoustics and morphologic features in FMR patients. Conclusions: Our study found the PM longitudinal strain decreased with an increase of FMR degree, both of function and desynchronization of APM and PPM play important role in FMR occurrence. Specifically, our results part explained the phenomenon that cardiac resynchronization therapy can reduce the degree of FMR. So these findings may helpful to screen right patients for this therapy.