Assessment of right ventricular mechanics in patients with mitral stenosis by two-dimensional deformation imaging.
BACKGROUND
It is well known that right ventricular (RV) dysfunction occurs early before clinical systemic congestion in patients with mitral stenosis (MS). Therefore, we aimed to evaluate the role of two-dimensional (2D) strain imaging in the assessment of subclinical RV dysfunction.


METHODS
Fifty-nine patients with isolated MS (mild and moderate) and 31 healthy control subjects constituted the study population. RV peak longitudinal strain (RV-LS) and strain rate (RV-LSr) measurements were obtained from apical four-chamber view.


RESULTS
There were no significant differences in left ventricular ejection fraction (LV-EF) and RV fractional area change between control and MS groups. RV strain (23.5 ± 7.2 vs. 18.63 ± 6.3, P = 0.001) and RV strain rate (1.72 ± 0.54 vs. 1.37 ± 0.66, P = 0.01) measurements were significantly lower in patients with MS than the control group. However, RV strain and strain rate measurements were comparable between MS subgroups. Correlation analysis revealed that there was poor correlation between RV-LS/LSr and mean-maximum gradients and echoscore but moderate correlation between RV-LS and RV-Sr in systolic pulmonary artery pressure and planimetric mitral valve area.


CONCLUSIONS
We demonstrated that patients with MS had lower RV functions using 2D strain imaging and this is independent from severity of MS. In the detection of subclinical RV dysfunction in patients with MS, 2D strain imaging appears to be useful. (Echocardiography, 2012;00:1-6).
Erzurum Education and Research Hospital, Erzurum, Turkey. haliltanboga@yahoo.com
Ibrahim Halil
IH
Tanboga
Mustafa
M
Kurt
Emine
E
Bilen
Enbiya
E
Aksakal
Ahmet
A
Kaya
Turgay
T
Isik
Mehmet
M
Ekinci
Süleyman
S
Karakoyun
Serdar
S
Sevimli
D000328:Adult; D015150:Echocardiography, Doppler / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*