Assessment of Left Ventricular Function in Patients Complicated with Rheumatic Mitral Stenosis using Strain/Strain Rate Trans-Thoracic Echocardiography

Background: Rheumatic valvular heart disease may affect the left ventricular function due to either inflammatory involvement and/or associated hemodynamic disturbance. Rheumatic mitral valve stenosis doesn’t affect LV function at early stages but, in the late stage, untreated significant mitral stenosis clinical left ventricular dysfunction may be observed. Patients with mitral stenosis have been observed to exhibit ultrastructural abnormalities in LV muscle cells. Strain and strain rate echocardiography are imaging modalities that may help to diagnose subclinical dysfunction of multiple cardiac chambers. SR/SRE were selected over tissue Doppler velocities because they are not impacted by push-pull forces. Preload and heart rate influence SE, but neither factor affects SRE. Utilizing strain/strain rate imaging, the left ventricular function of participants with rheumatic mitral stenosis was evaluated. Methods: This was a comparative (case-control) prospective study. 57 subjects were included in the study. The study comprised two groups. There were 32 patients with isolated severe mitral valve stenosis and 25 control cases, all of whom had little or no symptoms (NYHA classes I or II). Results: The LA, RA, and RV values were significantly lower in cases compared to controls when examining the general features of patients with mitral stenosis and healthy controls. When compared to controls, peak systolic strain was substantially lower in patients. Compared to controls, patients had considerably lower peak systolic strain rates. Conclusion: Even though the individuals with mitral stenosis had a normal global ejection fraction and no overt signs of heart failure, an echocardiogram indicated LV dysfunction. In the early phases of mitral stenosis, novel echocardiographic techniques like strain/strain rate imaging and TDI may be helpful for evaluating LV function.