title: Left ventricular mechanics in isolated mild mitral stenosis: a three dimensional speckle tracking study.
abstract: In a fraction of patients with mild mitral stenosis, left ventricular systolic function deteriorates despite the lack of hemodynamic load imposed by the dysfunctioning valve. Neither the predisposing factors nor the earlier changes in left ventricular contractility were understood adequately. In the present study we aimed to evaluate left ventricular mechanics using three-dimensional (3D) speckle tracking echocardiography. A total of 31 patients with mild rheumatic mitral stenosis and 27 healthy controls were enrolled to the study. All subjects included to the study underwent echocardiographic examination to collect data for two- and three-dimensional speckle-tracking based stain, twist angle and torsion measurements. Data was analyzed offline with a echocardiographic data analysis software. Patients with rheumatic mild MS had lower global longitudinal (p < 0.001) circumferential (p = 0.02) and radial (p < 0.01) strain compared to controls, despite ejection fraction was similar for both groups [(p = 0.45) for three dimensional and (p = 0.37) for two dimensional measurement]. While the twist angle was not significantly different between groups (p = 0.11), left ventricular torsion was significantly higher in mitral stenosis group (p = 0.03). All strain values had a weak but significant positive correlation with mitral valve area measured with planimetry. Subclinical left ventricular systolic dysfunction develops at an early stage in rheumatic mitral stenosis. Further work is needed to elucidate patients at risk for developing overt systolic dysfunction.
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Poyraz
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Tuğba Kemaloğlu
authors.initials: TK
authors.lastname: Öz
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Gönül
authors.initials: G
authors.lastname: Zeren
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey. tsguvenc@gmail.com.
authors.forename: Tolga Sinan
authors.initials: TS
authors.lastname: Güvenç
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Dönmez
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Can
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Rengin Çetin
authors.initials: RÇ
authors.lastname: Güvenç
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey.
authors.forename: Şennur Ünal
authors.initials: ŞÜ
authors.lastname: Dayı
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D015150:Echocardiography, Doppler / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: Myocardial deformation imaging; Rheumatic mitral stenosis; Speckle tracking echocardiography; Three-dimensional echocardiography