Ventricular strain patterns in multivalvular heart disease: a cross-sectional study

Abstract

Multivalvular heart disease (MVD) is an aggregate of regurgitant and/or stenotic lesions of at least two cardiac valves. Ventricular tissue deformation imaging is a powerful predictor of subclinical myocardial dysfunction in patients with MVD.The aim of this study was to examine the left and right ventricular strain patterns in MVD as well as observe any association between right–sided valvular involvement (tricuspid or pulmonary valve lesion) with that of aortic and/or mitral valve lesion. Patients with at least moderate forms of MVD were included in the present study. 72 patients with mean age of 56.69 ± 14.59 years and various presentations of MVD were finally enrolled in this study. The commonest cause for MVD was rheumatic heart disease in these patients. Conventional 2-dimensional parameters as well as tissue deformation imaging parameters were assessed in offline mode for these patients. The Mean ± SD values for various quantitative 2D echocardiographic conventional and tissue deformation imaging were assessed. It was observed that LV strain parameters including the global longitudinal strain (GLS) were preserved whereas the RV strain parameters were mildly reduced (RV GLS total is − 19.49 ± 6.08%). Also, when conventional echocardiographic parameters were assessed to see any association between aortic and/or mitral valve disease with that of right-sided valvular lesions (tricuspid or pulmonary); 2D conventional echocardiographic parameters like left atrial dimension (p = 0.034), TAPSE (tricuspid annular plane systolic excursion) (p < 0.001), RVSP (right ventricular systolic pressure) (p < 0.001) and IVC (inferior vena cava) dimensions (p < 0.001) showed a statistically significant result; whereas, when strain parameters for LV and RV were assessed, they did not show any statistical difference for the same. In this series of patients with significant MVD, our findings suggest that ventricular strain parameters may be reliable markers of myocardial dysfunction, but may alter depending on the underlying combination of MVD, and right ventricular strain should also be an important parameter while assessing different combinations of MVD.

Longitudinal Assessment of Left Ventricle Systolic Function in Acute Myocardial Infarction Patients Post Percutaneous Coronary Intervention

“…Once the region of interest is chosen, the software automatically presents the strain and strain rate curve forms for various areas, along with a Bull's eye representation of the 17 segments. Strain rates at peak systole, early diastole and late diastole were obtained 4 .GLS was calculated automatically as the average of global peak systolic strain from each of three views. Out of 258 patients, 111 had regular follow up and all the parameters were taken again and adverse outcomes noted.…”

Distribution, Etiology and Myocardial deformation imaging by speckle-tracking echocardiography in Valvular heart disease: A sub-analysis from a Clinical Registry

“…The study found that LV-GLS in these patients were preserved whereas RV-GLS was mildly reduced. The author concluded that higher level of pulmonary pressure and RV pressure overload lead to these ndings 43 . Similar results were found in the present study.…”

Non-Invasive Assessment of Multivalvular Heart Disease: A Comprehensive Review

“…To date, data on the diagnostic and prognostic utility of strain analysis in MVD are lacking. A study on 72 patients showed that LV strain parameters were not altered, but RV strain parameters were mildly reduced, suggesting an overload of the RV due to the presence of combined left-sided valvulopathies [ 56 ]. Further studies are needed to investigate the role of deformation index analysis in patients with MVD.…”