Assessment of left ventricular rotation in rheumatic mitral stenosis patients by velocity vector imaging

Objective To assess the regional left ventricular (LV) rotation motion in the patients with rheumatic mitral stenosis (MS) with velocity vector imaging (VVI).Methods This study included 38 patients with isolated MS (mild,moderate and severe) and 55 healthy control subjects.Short-axis parasternal views at the basal and apical level of LV were taken.Peak value of rotation angle and rotation velocity,as well as time to peak value were measured by VVI workplace offline respectively.Results ①In the healthy control subjects LV rotates clockwisely at the base and counterclockwisely at the apex,the same as the patients with MS.② In th patients with MS,rotaion angle and rotation velocity were significantly reduced at the apical level(P ＜0.001),rotation velocity were significantly reduced at some segments of basal level (anterior,lateral,septal) (P ＜ 0.05).③Compared with the healthy control,the difference of time to peak roation angle between base and apex was significantly longer in patients with MS (P ＜0.05).④ There were no significant differences among mild,moderate and severe MS (P ＞0.05).Conclusions The patients with MS may suffer from systolic dysfunctin even in the early stage identified by the alteration of LV rotation motion,which is independent of the hemodynamic severity of MS. Key words: Echocardiography; Rheumatic heart disease; Mitral valve stenosis; Ventricular function,left ; Velocity vector imaging