P-105 Impact of Left Atrial Remodeling After Successful Mitral Ballon Valvuloplasty on Long-Term Clinical Outcome

Abstract

Objective: Left ventricular postsystolic shortening (PSS) has been observed in dysfunctional myocardium as well as in normal subjects. Doppler echocardiographic features have been proposed to differentiate between normal and pathologic PSS. We studied the prevalence and characteristics of PSS in normal subjects, hypertension with left ventricular hypertrophy and ischemic heart disease (IHD) using Strain Imaging. Method: Strain Imaging parameters including peak systolic strain, magnitude of postsystolic strain and time to peak postsystolic strain were obtained for each left ventricular segment. Each group comprises 20 subjects (320 segments in normal group, 320 in hypertension and 126 in IHD group). For IHD, only segments with systolic wall motion abnormalities were studied. Results: PSS was present in 28% of segments in the normal group, 43% in hypertension group and 72% in ischemic group. Peak systolic strain was significantly lower in the ischemic group ( 9.4%) compared with hypertensive ( 15.8%) and normal ( 17.5%) groups. Postsystolic strain was higher in the ischemic ( 4.3%) and hypertension ( 3.7%) than in the normal group ( 1.6%). Time to peak systolic strain was significantly longer in the ischemic group (118ms) compared to the hypertension group (86ms) and normal group (69ms). Conclusion: Presence of PSS in hypertension is characterised by a higher magnitude than in normal subjects and is likely to reflect myocardial dysfunction. However, it may be distinguished from PSS in IHD by shorter time to peak postsystolic strain and higher peak systolic strain.