Key result
Patients with isolated rheumatic mitral stenosis and normal global ejection fraction had significantly lower systolic myocardial velocity (6.0 vs 7.9 cm/sec) and peak systolic strain compared to healthy controls.
Why the study?
Does strain/strain rate imaging detect subclinical left ventricular dysfunction in asymptomatic patients with rheumatic mitral stenosis?
Cross-Sectional (n=57)
No
Does strain/strain rate imaging detect subclinical left ventricular dysfunction in asymptomatic patients with rheumatic mitral stenosis?
Absolute Event Rate: 6% vs 7.9%
p-value: p=<0.001
Strain and strain rate imaging can detect subclinical left ventricular systolic dysfunction in patients with isolated rheumatic mitral stenosis who have normal global ejection fraction and no heart failure symptoms.
Strain imaging may detect subclinical LV dysfunction in rheumatic mitral stenosis with preserved EF; hypothesis-generating, needs prospective validation.
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 cm(2) (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.
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Şimşek et al. (2010) conducted a cross-sectional in Rheumatic mitral stenosis (n=57). Rheumatic mitral stenosis vs. Healthy controls was evaluated on Systolic myocardial velocity (Sm) (p=<0.001). Patients with isolated rheumatic mitral stenosis and normal global ejection fraction had significantly lower systolic myocardial velocity (6.0 vs 7.9 cm/sec) and peak systolic strain compared to healthy controls.
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