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Background The impact of successful percutaneous balloon mitral valvuloplasty (PBMV) on left ventricular (LV) function has been a controversial subject. This study aimed to determine the immediate impact of PBMV on biventricular function using recent Tissue Velocity Imaging (TVI) derived load-independent indices. Methods and results A total of 30 patients with severe mitral stenosis (MS) who underwent PBMV at a tertiary center of India from August 2012 to December 2013 were included in the study. Thirty age-matched and gender-matched healthy controls were also enrolled. Out of 30 patients, 27(90%) were female. Mean mitral valve area (MVA) of patients before and after PBMV was 0.78 and 1.82 cm 2 (p < 0.001), respectively. All TVI-derived LV and RV basal systolic (IVCV, Sm and the relatively load independent IVA) and diastolic velocities (Em, Em/Am) were significantly decreased in patients with MS compared to controls (p < 0.001 for all) which improved significantly after PBMV (6.4 ± 0.7 vs 11 ± 1.6; 5.8 ± 0.7 vs 9.9 ± 1.6; 1.5 ± 0.3 vs 4.2 ± 0.6; 6.4 ± 0.6 vs 13.1 ± 2.1; 0.7 ± 0.1 vs 1.7 ± 0.2 for mitral annulus respectively, p < 0.001 for all). Increment in MVA positively correlated with Tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular Sm and isovolumic contraction velocity (IVCV) and inversely with left atrium (LA) size and Pulmonary arterial systolic pressure (PASP) (p = 0.01 for LA size; p < 0.001 for others) while no such correlation was found with mitral annulus isovolumic acceleration (IVA) (r = −0.078; p = 0.679). Conclusion The improved right ventricular (RV) function appears to be predominantly due to afterload reduction, while that of LV appears to be more due to the acute relief of mechanical restraint.

Objectives: Cardiovascular risk factors for acute coronary syndrome (ACS) are on rise in people of Indian origin. Moreover, the prevalence of metabolic syndrome (MS) is higher in populations with ACS than in the general population. Thus, the aim of the study was to evaluate the cardiovascular risk factor profile of patients presenting with acute coronary syndrome and to study the prevalence and impact of metabolic syndrome in patients with acute coronary syndrome by using South Asian modified National cholesterol Education Program Adult Treatment Panel III definition. Methods: This study was conducted between October, 2010 and March, 2011 at Government General Hospital, Kurnool, India. A total of 100 patients with ST or non-ST segment elevation ACS and who had clinical, electrocardiographic and biochemical diagnosis within the first 24 hrs of clinical onset were enrolled in the study. The enrolled subjects were divided into two groups: those with MS and those without MS. Cardiovascular risk factors defined by components of MS were evaluated. Analysis was performed using SPSS software. Results: Sixty patients had MS along with ACS and 40 patients had ACS without MS. The most prevalent component of MS was increased waist circumference (83.3%), followed by increased triglycerides (78.3%) and increased fasting blood sugar (76.7%). Majority of patients (58.3%) had presence of three components of MS. Conclusion: The MS is a highly prevalent condition among the patients with ACS and is associated with severe coronary artery disease. The identification of MS imparts a high risk status to the patient in developing cardiovascular disease but at the same time provides abundant opportunities for intervention. Hence it is of paramount importance to aim for stricter goals and lower cut offs for intervention at all levels of prevention: primordial, primary and secondary.