459 Remodelling vs restrictive ring annuloplasty in severe mitral regurgitationand left ventricular dysfuntion

) and 41.2±9.9 mm Hg, respectively. It was determined that the IVV (0.11±0.03 cm/s vs 0.15±0.02 cm/s, p<0.001) and the IVA (2.3±0.7 m/s 2 vs 2.9±0.4 m/s 2 , p<0.001) of the RV was significantly lower and the right ventricular MPI increased (0.60 ± 0.2 vs 0.28 ± 0.06, p<0.001 ) in pa- tients with MS. It was also demonstrated that the MVA, left atrial diameter, mean diastolic gradient, and PAP were strongly correlated with IVA (r=-0.71 (p<0.001), r=0.42 (p=0.003), r=-0.55 (p<0.001), and r=-0.51 (p<0.001), respectively). Additionally the correlation between right ven- tricular IVA and MPI (r=-0.78 (p<0.001)) was significant. Systolic move- ment of the tricuspid annulus, Pat and FS were not sensitive in detecting the severity of the MS. Conclusion: This study demonstrate that the tissue Doppler systolic pa- rameters of right ventricular IVA is an important marker to assess the severity of mitral stenosis in patients with rheumatic valve diseases. A. O. Monaldi, Cardiology Dept., Naples, Italy Background: Mitral stenosis (MS) causes left atrium (LA) enlargement and dysfunction, resulting in reduced LA flow velocity. Tissue Doppler imaging (TDI) assesses regional myocardial function noninvasively; particularly Strain Rate (SR) imaging enables quantitative measurement of atrial reservoir func- tion. Aim of the study: To evaluate the effect of MS on right and left atrial (LA/RA) reservoir function using Strain(S) and SR and to compare atrial myocardial deformation properties in MS patients with sinus rhythm and in those with atrial fibrillation (AF). Methods: We studied 85 subjects: 33 (28 F, 5 M) healthy subjects (52 years) and 52 patients with isolated mitral stenosis: 16 with chronic AF and 36 in sinus rhythm, without CAD, hypertension, diabetes mellitus, left ventricular (LV) dysfunction (EF<50%), LV dilatation, LV hypertro- phy or other valvular disease. By Echocardiography System Seven GE equipped with TVI function were measured: mitral valve area in 2D and with PHT, mean mitral valve gradient, Wilkins' scores, LA/RA Volume (maximum and minimal), LA/RA EF (%), right ventricule systolic pres- sure, LA diameters. Peak systolic tissue atrial S and SR were evaluated in apical 4 and 2 chambers view at the level of the mid segment of the septal, lateral, anterior and inferior atrial walls, and at the mid segment of the RA free wall. Results: MS patients had significantly larger LA dimension and signifi- cantly lower LA ejection fraction than controls. LA EF in patients with MS (media 28.32%) was lower than LA EF in controls (44.35%) and LA maxi- mal volume was greater in patients with MS (97.63 mL) in comparison with controls (24.51 mL). The myocardial atrial S and SR were found to be significantly (p<0.01) lower for each atrial wall in patients with pure MS compared to controls (46±15 vs 75±18%). Patients with AF + MS showed significant (p<0.01) more compromised atrial myocardial deformation properties than MS patients in sinus rhythm (25±10 vs 55±18%). A sig- nificant correlation was found between left atrial S and mitral valve area (p=0.03; R=-0.51) and between atrial S and mean gradient (p=0.005; R=-0.63) accross the mitral valve. Conclusion: Strain Imaging is an echocardiography technique useful to study ass esment of LA function in patients with MS noninvasively. Atrial myocardial deformation properties are compromised in patients with MS; this impairment is more pronounced in patients with MS + AF.