To assess the strain and synchronism of left ventricular papillary muscles (PM) in functional mitral regurgitation (FMR) patients using two-dimensional speckle tracking echocardiography, and to explore the relation of PM function and the development of FMR.

Sixty ischemic cardiomyopathy patients with FMR and 60 idiopathic dilated cardiomyopathy patients with FMR were prospectively recruited. They were divided into three groups as the degree of FMR, patients with mild FMR was group F1, with moderate FMR was group F2, with severe FMR was group F3. Control group involved 42 healthy volunteers. The longitudinal peak strain of anterior and posterior PM (ALS, PLS), the peak time of longitudinal peak strain (APT, PPT), and the delay time of peak value between ALS and PLS (DT) were quantified.

The ALS and PLS decreased company with increased of FMR degree (P<0.05, respectively), whereas the DT increased (P<0.05, respectively), and there was no significant variation trend of the APT and PPT. There was no intergroup difference of ALS and PLS, APT and PPT (P>0.05, respectively). ALS, PLS had negative correlation with LVM(P<0.05, respectively), and positive correlation with LVEF (P<0.05, respectively). DT had positive correlation with LVM(P<0.05), and negative correlation with LVEF (P<0.05).

The dysfunction and desynchronization of PM are closely related to the severity of FMR.The results may helpful to screen proper patients for cardiac resynchronization treatment.

Echocardiography; Mitral valve insufficiency; Myocardial ischemia; Speckle tracking imaging