Assessment of Right Ventricular Function in Patients with Mitral Stenosis Before and After Percutaneous Balloon Mitral Valvuloplasty Using Two-Dimensional Speckle-Tracking Echocardiography as Well as Conventional Echocardiography

Abstract Background: Severe mitral stenosis (MS) leads to impairment in right ventricular (RV) function. Quantification of the RV strain by two-dimensional speckle-tracking echocardiography (2D-STE) is an emerging diagnostic technique. We aimed to assess RV function as quantified by 2D RV global longitudinal strain (RVGLS) and other conventional echocardiographic parameters in patients with moderate or severe MS, before and 1 month after percutaneous balloon mitral valvuloplasty (BMV). Methods: In this prospective, observational, hospital-based study, 30 patients with moderate-to-severe MS with normal coronary angiogram who were scheduled to undergo percutaneous BMV were included. The assessment of RV function was carried out by conventional echocardiography as well as 2D-STE before and 1 month after BMV. Results: The mean age of the study population was 35.6 ± 16.4 years; females (66.7%) were predominantly affected with MS. There was a significant increase in mitral valve area (1.6 ± 0.2 cm 2 vs. 0.9 ± 0.2 cm 2 ; P = 0.0086), RV ejection fraction (46.0 ± 9.0% vs. 41.4 ± 9.6%; P < 0.0001), and RVGLS (23.8% vs. 21.6%; P < 0.0001) after percutaneous BMV. Significant reduction was noted in mean mitral pressure gradient (4.8 ± 1.9 mmHg vs. 14.0 ± 5.0 mmHg; P < 0.0018), tricuspid regurgitation gradient (26 ± 18.4 mmHg vs. 39.0 ± 28.6 mmHg; P < 0.0001), RV end-diastolic volume (34.9 ± 14.1 ml vs. 37.0 ± 20.3 ml; P < 0.0001), and RV end-systolic volume (19.1 ± 5.7 ml vs. 22.5 ± 10.0 ml; P < 0.0001) after percutaneous BMV. Conclusion: Percutaneous BMV resulted in significant improvement of RV function as assessed by 2D speckle tracking in our patients who had moderate to severe mitral stenosis.