title: Importance of left ventricular longitudinal function and functional reserve in patients with degenerative mitral regurgitation: assessment by two-dimensional speckle tracking.
abstract: BACKGROUND
  The aim of this study was to determine whether two-dimensional speckle tracking of longitudinal myocardial deformation can detect limited contractile reserve during exercise in patients with asymptomatic degenerative mitral regurgitation (MR).
  
  
  METHODS
  Seventy-one patients with degenerative MR and normal left ventricular (LV) ejection fractions underwent quantitative exercise echocardiography.
  
  
  RESULTS
  Compared with 23 normal subjects matched for age and sex, LV volumes were greater in patients with MR. At rest, global longitudinal strain (GLS) was lower in patients, indicating subclinical LV dysfunction. During exercise, the extent and the magnitude of changes in GLS were larger in controls than in patients with MR. On multivariate regression analysis, left atrial volume at rest and changes in GLS at peak exercise were independently associated with changes in LV ejection fraction.
  
  
  CONCLUSIONS
  In asymptomatic patients with degenerative MR, subnormal LV function can be reliably identified by two-dimensional strain imaging. Limited exercise LV longitudinal contractile recruitment during exercise predicts postoperative LV dysfunction.
authors.affiliation: Department of Cardiology, University Hospital Sart Tilman, Liège, Belgium. plancellotti@chu.ulg.ac.be
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
authors.forename: Bernard
authors.initials: B
authors.lastname: Cosyns
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zacharakis
authors.forename: Emilio
authors.initials: E
authors.lastname: Attena
authors.forename: Guy
authors.initials: G
authors.lastname: Van Camp
authors.forename: Olivier
authors.initials: O
authors.lastname: Gach
authors.forename: Marc
authors.initials: M
authors.lastname: Radermecker
authors.forename: Luc A
authors.initials: LA
authors.lastname: Piérard
mesh_terms: D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*