Longitudinal right ventricular function as a predictor of functional capacity in patients with mitral stenosis: an exercise echocardiographic study.
BACKGROUND
The influence of right ventricular (RV) function on exercise capacity has been poorly explored in mitral stenosis (MS). The objective of this study was to assess the determinants of functional status with exercise echocardiography in MS.


METHODS
Thirty-nine patients (55 +/- 12 years, 29 female) with MS (1.3 +/- 0.5 cm(2)) underwent an exercise echocardiography (14 patients had previous balloon valvuloplasty). RV function was assessed by tricuspid annulus S-wave velocity (Tric-S) and tricuspid annular plane systolic excursion (TAPSE).


RESULTS
Tric-S correlated with TAPSE (P = .03), cardiac output (P = .006), and mitral valve area (P = .009). With exercise, Tric-S and TAPSE increased significantly (11.3 +/- 3.1 cm/s to 15.5 +/- 3.4 cm/s and 21.2 +/- 5.2 mm to 24.0 +/- 5.8 mm, respectively, both P < .05). TAPSE was lower in patients in New York Heart Association class 3 or 4. In multivariate analysis, Tric-S at rest (beta = 0.34, P = .006) and mitral Delta mean diastolic gradient (beta = 0.34, P = .006) were the independent determinants of maximum workload.


CONCLUSIONS
Resting RV longitudinal function assessed through Tric-S is an important determinant of functional capacity in MS.
Deswarte
Guillaume
G
Service d'Explorations Fonctionnelles, Cardiology University Hospital, CHRU, Lille, France.
Richardson
Marjorie
M
Polge
Anne Sophie
AS
Pouwels
Sébastien
S
Ennezat
Pierre Vladimir
PV
Trochu
Jean-Noël
JN
Wallaert
Benoit
B
Deklunder
Ghislaine
G
Le Tourneau
Thierry
T
D000328:Adult; D025401:Echocardiography, Stress; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016278:Ventricular Function, Right