Evaluation of the effect of percutaneous mitral balloon valvuloplasty on left ventricular systolic functions using strain and strain rate echocardiography

Abstract

Background/aim: This study aimed to evaluate the effect of successful percutaneous mitral balloon valvuloplasty (PMBV) on left ventricular systolic functions using strain and strain rate echocardiography in moderate-severe mitral stenosis (MS) patients with normal left ventricular systolic function confirmed by conventional echocardiography. Materials and methods: Patients with moderate-severe MS who had undergone successful PMBV were included. Conventional echocardiographic parameters were evaluated before and after PMBV. Peak systolic strain and strain rate values of basal, mid, and apical segments of the left ventricular anterior, inferior, septum, and lateral walls were determined. Results: After PMBV, significant decreases were determined in the peak and mean gradients of the mitral valve and pulmonary artery pressure, but a significant increase in the mitral valve area. Significant increases (improvement) were determined in the peak systolic strain and strain rate in the basal, mid, and apical segments of the left ventricular septum, lateral, anterior, and inferior walls and in the left ventricular global peak systolic strain (-17.32 ± 0.58% vs.-12.38 ± 1.06%) and strain rate (-1.65 ± 0.07 vs.-1.22 ± 0.12). Conclusion: Strain and strain rate echocardiography can be used for quantitative evaluation of the effect of PMBV on the left ventricular systolic functions in moderate-severe MS patients.

Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty

“…After PBMV, a Doppler study indicated a considerable improvement in the overall function of the left ventricle [5].…”

Fluoroscopy versus Transthoracic Echocardiography for Detection of Mitral Valve Calcification in Patients Undergoing Percutaneous Mitral Balloon Valvuloplasty

“…Chen et al, in a multicenter study, which included 4832 (70% female) MS patients, the procedure success rate was 99%. 21 Güntürk EE et al 23 successfully performed PMBV (mean MCA increased from 1.1 cm 2 to 1.6 cm 2 ) in 30 patients, 80% of whom were women, with a mean age of 32 years, and did not report any significant cardiovascular complications. 23 In another study, Tomai F et al 24 , studied a total of 482 consecutive patients, and successful PMBV treatment was achieved in 91% of patients.…”

“…21 Güntürk EE et al 23 successfully performed PMBV (mean MCA increased from 1.1 cm 2 to 1.6 cm 2 ) in 30 patients, 80% of whom were women, with a mean age of 32 years, and did not report any significant cardiovascular complications. 23 In another study, Tomai F et al 24 , studied a total of 482 consecutive patients, and successful PMBV treatment was achieved in 91% of patients. The group of 45 (8.5%) patients had suboptimal valve dilation (post-PMV valve area <1.5 cm 2 ), severe MR, and need for surgery (repair or replacement).…”

Percutaneous balloon mitral valvuloplasty in rheumatic mitral stenosis: the earlier the merrier?

“…Several studies have examined these parameters in MS ( 14) and analyzed how they changed following PBMV (15,16). The lack of investigation of the PBMV effects by strain and strain rate imaging was acknowledged as a limitation by the authors themselves.…”

“…The lack of investigation of the PBMV effects by strain and strain rate imaging was acknowledged as a limitation by the authors themselves. Multiple studies have already suggested to perform early PBMV in patients with confirmed subclinical LV dysfunction, even if they are still asymptomatic (7,15). Indeed, an inverse correlation was noted between baseline MPI and the magnitude of change in MPI after PBMV, implicating that intervening before significant worsening of LV function may produce better long-term outcomes (7).…”