Assessment of left ventricular function in patients with rheumatic mitral stenosis using speckle tracking echocardiography

Background: Rheumatic mitral stenosis (MS) is a prevalent condition in developing nations and is associated with numerous complications. Assessing left ventricular (LV) function plays a crucial role in predicting outcomes and tailoring treatment strategies for patients with various cardiac disorders. Aim: Our objective was to investigate the prevalence of left ventricular (LV) systolic dysfunction in individuals with predominant rheumatic mitral stenosis. Patents and Methods: One hundred rheumatic MS patients were evaluated and compared with 30 healthy individuals as a control group. We excluded any patient with any obvious cause affecting LV systolic function (Significant MR, other valve affection, cardiomyopathies, hypertension, diabetes and coronary artery disease). All subjects were estimated utilizing 2D and speckle tracking echocardiography Results: Both global basal and mid segment strain were significantly lower in patients with MS despite normal LV dimension and systolic function. Moreover, the segmental strain of all basal and mid segments was significantly lower in MS patients. However, global apical strain did not differ significantly in statistical terms. Conversely, the mean transmitral pressure gradient demonstrated a significant negative association with basal and mid longitudinal strains, alongside a significant positive association with apical longitudinal strain. Conclusion: 2D strain analysis reveals lower left ventricular functions in MS patients, possibly due to rheumatic myocardial involvement, making 2D strain imaging useful for detecting subclinical LV dysfunction.