Evaluation of left ventricular function with strain/strain rate imaging in patients with rheumatic mitral stenosis

Objective: The most important sequel of acute rheumatic fever is mitral stenosis in long-term. The aim of the study is to determine left ventricular (LV) functions by tissue Doppler imaging (TDI) and strain/strain rate echocardiography (SE/SRE) in mitral stenosis patients who had no clinical signs of heart failure. Methods: Our study was designed as cross-sectional study. The study population consisted of 32 patients with isolated mitral stenosis and mitral valve area 2.0 cm2 (Group 1) and 25 healthy control subjects (Group 2). In addition to standard echocardiographic methods, TDI and SE/ SRE were performed to assess LV functions in all participants. Student’s t-test was used to compare continuous variables. Fisher- exact test was used to compare categorical variables. Results: Systolic myocardial velocity (Sm) were significantly lower in Group 1 than in Group 2 (6.0±1.4 cm/sec vs 7.9±1.8 cm/sec, p 0.001) also, early diastolic myocardial velocity (Em) were significantly lower in Group 1 than in Group 2 (4.4±1.5 cm/sec vs 10.8±2.1 cm/sec, p 0.001). But there was no significant difference in late diastolic myocardial velocity (Am) between two groups. Peak systolic strain and strain rate of septal wall in Group 1 were significantly lower than Group 2 (p 0.001 for both). Besides, peak systolic strain and strain rate of lateral wall in Group 1 were significantly lower than in Group 2 (p 0.001 for both). Conclusion: Although, global ejection fraction was normal and there were no symptoms of heart failure clinically in the patients with mitral stenosis, LV dysfunction demonstrated that using by echocardiography. TDI and strain/strain rate imaging to be new echocardiographic methods may be used reliably for detection LV function in early stage of mitral stenosis.