Echocardiographic Strain imaging to assess immediate and short term effects of successful percutaneous balloon mitral valvotomy on Left Atrial and Right Ventricular Mechanics

Abstract

Background Strain imaging for Left atrium and Right Ventricle has been used as a novel assessment tool to evaluate LA and RV functional status. However, their implication is not fully established regarding the effect of percutaneous balloon mitral valvotomy (BMV) in patients with rheumatic severe mitral stenosis (MS). In the present study, we sought to assess the Global LA Strain and RV Strain in this patient population. Methods It is an observational study and was conducted in a tertiary health care centre of North India from the Year 2018 to 2020. 66 consecutive patients with suitable mitral valve anatomy for BMV procedure were taken, out of which 38 patients could be followed up till 3 months. Global LA strain and RV Strain were being calculated using special software (GE Healthcare, ECHO PAC Version 203) at three temporal sequences. Results The mean age of the study population was 31.63 ± 10.15 years. Both Peak Left atrial longitudinal strain (PALS) and Global RV Longitudinal strain (GLSRV) were impaired in patients with severe MS and both significantly improved both at 24 hrs and 3 months following BMV. There was a significant positive correlation of LA strain and RV strain both at 24 hours and 3 months of follow up. (Pearson r = 0.9142). Conclusions Peak LA strain (PALS) and Global RV strain (GLS RV ) can be considered as an indicator of respectively left atrial and Right ventricular function, and its improvement may be taken as a good indicator of successful BMV.