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SummaryThe present study aimed to assess severity of mitral stenosis and aortic stenosis by using Doppler Tissue imaging.The study included 30 patients with mitral stenosis and 15 control individuals.And 15 patient with aortic stenosis and 15 control individuals .They were classified in two groups .Mitral stenosis group and aortic stenosis group.All patients were subjected to the followings.1- Full history taking.2- Thorough clinical examination.3- Resting 12-lead surface ECG.4- Conventional trans-thoracic echocardiography.5- Tissue Doppler echocardiography.The study showed the following :Mitral Stenosis GroupMyocardial velocities obtained by tissue Doppler imaging in MS patients. There is the decrease in myocardial velocities varied for each wall. There is the decrease in velocity of Sm in MS groups is highly statistically significant decrease in lateral, inferior, anterior, while Sm of IVS was statistically nonsignificant . There is a greater drop was measured for Anterior, inferior, Lateral, Walls in Em and highly significant decrease obtained , while the decrease in septal wall Em less than other walls . Am velocity was measured in patient with MS there is a greater significant decrease in lateral, Anterior , Inferior, walls more than septal wall , Lateral wall and left vent.mean Em / Am ratio were statistically significantly lower in MS patients. Myocardial velocities obtained from left ventricular wall annulus and their mean values showing global left ventricular function were found significant lower in patients with MS. There is significant positive correlation between MVA and left vent. Mean Am , and highly positive correlation with left vent. Mean Sm. there is a highly significant negative correlation between MVA and A/Am velocity, and highly significant positive correlation between max. trans. MPGr and A/ Am velocity. There is significant positive correlation between Left. Vent. mean Sm and EF, and significant positive correlation between EF and Em , There is highly significant negative correlation between PAP and MVA , there is significant positive correlation between PAP with LAD , and highly positive correlation with MPIAortic Stenosis GroupThe Maximum trans-aortic gradient increased in individuals with AS with high significant difference.Peak trans-aortic velocity is highly significant increased in patients with aortic stenosis than control group by dopplar tissue imaging ICT was significantly longer in patients with aortic stenosis and there is significant positive correlation between max. trans. aortic Pressure gradient and DT.ICT. There is highly significant negative correlation between max. pr. Gr. and aortic valve area . There is significant negative correlation between aortic valve area and DT.ICT. With the( ROC )curve the cut off value of DT.IcT in the diagnosis of severe AS was 90 m/sec. with sensitivity=83.3% , specifity = 88.9.ConclusionConclusions- Mitral Stenosis :Pure MS affects the movements of the left ventricle in the long axis.The reduction in systolic myocardial velocities, and the fact that shows a negative correlation with MVA, indicates functional changes rather than myocardial pathology. The different degree reduction in diastolic myocardial velocities suggest that myocardial pathology might also be effective in addition to functional changes,the left-ventricular MPI obtained by TDI is an important marker to PAP .Aortic Stenosis.ICT measured by pulsed DTI is increased in patients with aortic stenosis which can be applied in patients with poor acoustic window easier & faster than continuity equation to assess AS severity .Study LimitationsStudy LimitationsA. Mitral stenosis group :This study is on the basis of the evaluation of left ventricular function by using myocardial velocities along the long axisIn this study we excluded the following :- Patients with atrial fibrillation, which generally accompanies sever MS.
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