Assessment of right ventricular strain and strain rate in patients with severe mitral stenosis before and after balloon mitral valvuloplasty

Kumar, Vipin; Jose, V; Pati, P.; Jose, John

doi:10.1016/j.ihj.2014.02.012

Cited by 27 publications

(29 citation statements)

References 18 publications

(25 reference statements)

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“…This finding is concordant with that of Kumar et al 19 who found significantly lower regional strain at basal RV septum (À11.63 ± 6.63 vs. À18.22 ± 9.65; p = 0.02), mid RV septum (À9.31 ± 5.65 vs.À18.98 ± 3.25; p = 0.001), apical RV septum (À13.75 ± 5.32 vs. À19.69 ± 6.38; p = 0.005) and basal RV free wall segment (À19.35 ± 14.10 vs. À32.57 ± 14.98; p = 0.012) in patients with severe MS compared to health subjects. This again is concordant with Ozdemir et al 21 who found significantly lower RV septal strain (À19 ± 7 vs. À23 ± 5, P = 0.03) and strain rate (À1.2 ± 0.4 vs. À1.5 ± 0.3, P = 0.005) and normal RV free wall strain (À22 ± 8-26 ± 9, P > 0.05) and strain rate (À1.8 ± 0.5-1.8 ± 0.4, P > 0.05) in patients with mild-moderate MS compared to control group.…”

Section: Discussionsupporting

confidence: 92%

“…Our results were in agreement with those of Yildirimturk et al 1 who found significantly lower mean RV-GLS (À21.6 ± 5.4 vs. À25.4 ± 5.0, P = 0.049) and RV-GLSr (À1.21 ± 0.68 vs. À1.64 ± 0.24, P = 0.038) in patients with moderate-severe MS compared to control subjects, correlation analysis revealed significant inverse correlation between RV-GLS and mean transmitral gradient (r = À0.358, P = 0.027) and PASP (r = À0.586, P < 0.001) and significant inverse correlation between RV-GLS and PASP (r = À0.450, P = 0.005) in patients with MS. Additionally, Castro et al 18 found significantly lower mean RV 2D global longitudinal strain in patients with severe MS compared to healthy subjects (À17.5 ± 3.9% vs. À21.8 ± 3.4%; p = 0.007) and an inverse correlation between RV-GLS and PASP in patients with MS. A recently published study by Kumar et al 19 found significantly lower RV-GLS in patients with severe MS compared to control subjects (À14.67 ± 3.95 vs. 9.07 ± 4.70; p < 0.02) and an inverse correlation between RV-GLS and PASP (r = 0.416, p = 0.02).…”

Section: Discussionmentioning

confidence: 87%

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Detection of subclinical right ventricular systolic dysfunction in patients with mitral stenosis by two dimensional strain and strain rate imaging

Younan

2015

The Egyptian Heart Journal

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Introduction: Right ventricular (RV) systolic dysfunction occurs early before clinical systemic congestion in patients with mitral stenosis (MS). Conventional echocardiographic techniques have some limitations in the assessment of RV function. Aim of the work: To evaluate the role of two dimensional (2D) longitudinal systolic strain and strain rate imaging in detection of subclinical RV systolic dysfunction in patients with moderatesevere MS. Patients and methods: Fifty patients with isolated MS (moderate-severe) and 30 healthy control subjects constituted the study population. Conventional echocardiography, pulsed wave tissue Doppler imaging (TDI) of the tricuspid annulus and 2D longitudinal segmental and global RV systolic strain (RV-GLS) and strain rate (RV-GLSr) measurements were obtained. Results: Patients with MS had significantly lower RV-GLS and RV-GLSr compared to control subjects (À19.67 ± 6.23 vs. À24.19 ± 3.25, P < 0.001, and À1.49 ± 0.87 vs. À1.91 ± 0.56, P = 0.02, respectively). Conclusion: Patients with MS had significantly lower 2D RV-GLS and RV-GLSr compared to control group. 2D RV-GLS and RV-GLSr imaging appear to be useful in detection of subclinical RV systolic dysfunction in patients with MS.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 87%

Detection of subclinical right ventricular systolic dysfunction in patients with mitral stenosis by two dimensional strain and strain rate imaging

Younan

2015

The Egyptian Heart Journal

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“…Immediately after BMV, there was significant improvement in catheterization parameters (a wave, v wave, EDG, LA mean pressure, LVEDP). These findings are in concordance with the findings of Sengupta and Kumar et al 11,17 …”

Section: Discussionsupporting

confidence: 93%

“…This is in agreement with the data obtained by Ozdemiret aland Kumar et al 16,17 Immediately after BMV, there was significant improvement of the RV GLS compared with the RV GLS before BMV (post one month -17.37±5.72 versus post 24-48 hrs -13.87±8.93 versus baseline -9.43±5.75, P = 0.0001). Similar significant improvement was noticed by Kumar et al 17 This improvement could be due to the progress in the RV afterload as a result of the relief of the LV inflow obstruction.…”

Section: Discussionsupporting

confidence: 92%

“…16,17 There was difference in regional RV longitudinal strain, as seen in significant decrease in the RV strain values of the septal segments, but there was no significant difference between the RV free wall segments, and those in the healthy control group. This is in agreement with the data obtained by Ozdemiret aland Kumar et al 16,17 Immediately after BMV, there was significant improvement of the RV GLS compared with the RV GLS before BMV (post one month -17.37±5.72 versus post 24-48 hrs -13.87±8.93 versus baseline -9.43±5.75, P = 0.0001). Similar significant improvement was noticed by Kumar et al 17 This improvement could be due to the progress in the RV afterload as a result of the relief of the LV inflow obstruction.…”

Section: Discussionmentioning

confidence: 92%

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Evaluation of left and right ventricular functions pre and post balloon mitral Valvuloplasty using speckled tracking echocardiography

Mehta

Tripathi²

2017

Int J Res Med Sci

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Background: Rheumatic heart disease remains a considerable cause of cardiovascular morbidity and mortality in developing countries such as India. The aim of the present study was to compare ventricular (LV and RV) function in patients with severe mitral stenosis (MS) undergoing balloon mitral Valvuloplasty (BMV) with those on medical management and also with healthy controls and to assess the burden of ventricular (LV and RV) systolic dysfunction, its determinants, and its reversibility with percutaneous balloon mitral Valvuloplasty using speckle tracking echocardiography in patients with severe MS.Methods: This prospective study was performed in a tertiary care center, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow in patients with severe MS, from September 2014 to September 2015. A total of 60 were divided into three groups. Cases (n=30), patients with severe MS undergoing BMV; case controls (n=20), patients with severe MS who did not give consent for BMV and chose medical management and healthy controls (n=10). Cases who underwent BMV were analyzed pre and post BMV and detailed echocardiographic and speckle-tracking echocardiography (STE) was done at baseline, 24-48 hours after BMV and at post one month after BMV. Appropriate statistical analysis was applied and different parameters were compared.Results: Most of the cases (56.7%) control (65%) and healthy controls (40%) were between 21-30 years of age. Female preponderance was observed in the study. A significant (p=0.01) decrease in the LA size, PASP (p=0.0001), MV PG area (p=0.0001) and significant (p=0.0001) increase in the LVEF, MVA area was observed from baseline to post 24-48 hours and at post one month after BMV among cases. Significant improvement was noticed in longitudinal strain and regional rotation in different LV segments as assessed by STE at post 24-48 hours and post one month after BMV (p value 0.001) among cases. No significant (p>0.05) difference in the 2D echo parameters was seen from baseline to follow-ups among the case controls. No significant improvement was observed in regional rotation, global rotation in different LV and RV segments after one month as assessed by STE among case controls whereas significant improvement was seen in cases.Conclusions: BMV results in marked improvement in LV and RV GLS immediately post BMV with improvement towards normalization at follow up after one month and the same can be easily assessed by Speckle tracking echocardiography.

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Assessment of right ventricular dysfunction in patients with mitral stenosis: A speckle tracking study

Kalkan

Aksakal

et al. 2019

J of Clinical Ultrasound

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Purpose: Although it is affected at an early stage, there is a lack of studies investigating right ventricular (RV) function in patients with mitral stenosis (MS). We aimed to investigate the correlation between conventional echocardiographic variables and tricuspid annular plane systolic excursion (TAPSE), used as an indicator of RV dysfunction.Methods: We enrolled 59 consecutive patients with MS and assigned them in group 1 if TAPSE ≤16, or group 2 if: TAPSE >16.Results: The mean age of the patients was 42.2 ± 8 years, and 74.6% were females.In univariate analysis, maximal mitral valve gradient, mean mitral valve gradient, systolic pulmonary arterial pressure, RV strain, and RV strain rates were associated with RV dysfunction. In multivariate analysis, both strain variables were found to be independent predictors of RV dysfunction. Kaplan Maier survival analysis showed that patients with lower RV strain had more rehospitalization rate during the one-year follow-up period.Conclusions: RV dysfunction is common in patients with MS and is associated with higher rehospitalization rate and morbidity. Evaluation of RV strain and strain rate for early detection of RV dysfunction and prediction of rehospitalization may be an appropriate approach in mitral stenosis. K E Y W O R D S echocardiography, mitral stenosis, right ventricle, strain

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Assessment of right ventricular strain and strain rate in patients with severe mitral stenosis before and after balloon mitral valvuloplasty

Cited by 27 publications

References 18 publications

Detection of subclinical right ventricular systolic dysfunction in patients with mitral stenosis by two dimensional strain and strain rate imaging

Detection of subclinical right ventricular systolic dysfunction in patients with mitral stenosis by two dimensional strain and strain rate imaging

Evaluation of left and right ventricular functions pre and post balloon mitral Valvuloplasty using speckled tracking echocardiography

Assessment of right ventricular dysfunction in patients with mitral stenosis: A speckle tracking study

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