The prognostic value of Mitral Annulus Velocities by Tissue Doppler Imaging after First Anterolateral Myocardial Infarction

Reduced left ventricular (LV) systolic and diastolic function after myocardial infarction (MI) is a common finding. Studies have shown that mitral valve annulus velocities change in this condition. We sought to evaluate the prognostic value of mitral valve annulus velocitiesby Tissue Doppler Imaging (TDI) in patients with first anterolateral wall MI and determine its relationship with early mortality. We enrolled 50 patients with first anterolateral wall MI and evaluated their LV function by mitral annulus velocity using TDI. We then compared these results with findings in a control group and also in expired patients. We also studied the LV ejection fraction (LVEF) and the regional wall motion abnormality index (RWMAI). The MI patients showed a significant reduction in mitral annulus peak systolic velocity and early and late diastolic velocities in the lateral, septal, and anterior sides compared with the control group. (For example,S, E and A velocities in the lateral side in the patient vs. the control group: 5.31 +/-1.80 vs. 13.9 +/-3.6; 7.1 +/-2.2 vs. 17.34 +/-4.54; 9.49 +/- 2.15 vs.18.3 +/-5.9, respectively; p value <0.001.) Moreover,all these parameters were very low in the expired patients.These findings had a significant correlation with the LVEF and RWMAI(p value <0.001). Mitral annular velocities can be easily measured by TDI after MI. Reduction in these velocities is a marker for LV regional dysfunction in systole and also for diastolic dysfunction. These findings correlate well withthe LVEF and RWMAI and increased mortality after MI.