Key result
Severe and very severe mitral stenosis was associated with substantially declined right ventricular systolic function markers (TAPSE, FAC, S', and RVFWS) compared with healthy controls.
Why the study?
RV failure impacts symptoms and prognosis in mitral stenosis, but the exact role, effect, and pathophysiology of RV dysfunction remain controversial.
Does severe and very severe mitral stenosis impair right ventricular systolic function as assessed by TDI and VVI compared to healthy controls?
Case-Control (n=69)
Does severe and very severe mitral stenosis impair right ventricular systolic function as assessed by TDI and VVI compared to healthy controls?
Right ventricular systolic function deteriorates in proportion to the severity of mitral stenosis, which can be effectively evaluated using TDI and VVI.
Severe MS was associated with reduced RV systolic function by TDI/VVI; hypothesis-generating and should not yet change practice.
Background: Right Ventricular (RV) failure has a critical role in the onset and progression of clinical symptoms and the prognosis of patients with Mitral Stenosis (MS), but the exact role, effect, and pathophysiology of RV dysfunction in MS is still controversial. In this study, we aimed to evaluate echocardiographic signs of systolic RV dysfunction using Tissue Doppler Imaging (TDI) and Velocity Vector Imaging (VVI) in subjects with severe and very severe MS. Methods: 46 isolated MS cases (23 severe and 23 very severe) and 23 healthy controls were enrolled in this study. RV function was assessed by tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and peak systolic velocity of the tricuspid annulus (S’) using TDI, and RV free wall strain (RVFWS) employing VVI. Furthermore, these values were compared with mitral valve area (MVA) and pulmonary arterial pressure (PAP). Results: TAPSE, FAC, S’, and RVFWS values were substantially declined in MS cases compared with healthy controls. Moreover, PAP values were considerably increased in MS subjects. Additionally, S’ and TAPSE values were significantly lower in very severe MS patients compared with severe patients. Conclusion: RV systolic function deteriorates in patients with severe and very severe MS. It appears that the degree of the severity of MS can proportionately affect the extent of RV dysfunction and some of its echocardiographic markers such as S’ and TAPSE. TDI and VVI can be used as practical early diagnostic methods for RV dysfunction in MS.
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Bigdelu et al. (2021) conducted a case-control in Severe and very severe Mitral Stenosis (n=69). Severe and very severe Mitral Stenosis vs. Healthy controls was evaluated on Right ventricular function assessed by TAPSE, FAC, S', and RVFWS. Severe and very severe mitral stenosis was associated with substantially declined right ventricular systolic function markers (TAPSE, FAC, S', and RVFWS) compared with healthy controls.
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