Evaluation of left ventricular posterior wall movement after open mitral commissurotomy by echocardiogram: with reference to the effect of papilloplasty.

Left ventricular posterior wall movement in 20 patients with mitral stenosis (MS) was measured using M-mode echocardiogram in order to evaluate the improvement of myocardial function after open mitral commissurotomy (OMC) and compared between the cases with (10 patients) and without (10 patients) papilloplasty. The maximum left ventricular end-diastolic posterior wall velocity (LVPEVdmax) was increased from 71 +/- 12 to 90 +/- 16 mm/s in OMC patients (p less than 0.01) and from 59 +/- 19 to 101 +/- 28 mm/s in OMC + P patients (p less than 0.001). The maximum left ventricular systolic posterior wall velocity (LVPWVsmax) showed an increase from 51 +/- 9 to 62 +/- 10 mm/s in OMC patients (p less than 0.02) and from 48 +/- 10 to 69 +/- 8 mm/s in the OMC + P group (p less than 0.001). The mean LVPWVs increased from 35 +/- 8 to 48 +/- 8 mm/s in the OMC + P group (p less than 0.01). These parameters correlate fairly well with stroke volume index (SVI), ejection fraction (EF), and fractional shortening (FS) derived from internal LV dimensions. Thus, the posterior wall movement may prove to be useful as an index for evaluating the improvement of LV function after OMC.