Evaluation of the impact of successful percutaneous balloon mitral valvuloplasty on the left ventricular twist and untwist mechanics by the two dimensional speckle tracking imaging

Abstract

Background: MS is one of the most prevalent valve abnormalities in people with chronic rheumatic heart disease (RHD). The effect of Inoue and multi-track successful percutaneous balloon mitral valvuloplasty (PBMV) on the twist and untwist mechanisms of the left ventricle was evaluated using non-invasive two-dimensional speckle tracking imaging (STI). Methods: This study was conducted on patients with mitral stenosis of rheumatic origin fulfilling the criteria for PBMV. Cases were categorized into two equal groups; group 1: 30 Patients underwent PBMV using Inoue technique and group 2: 30 Patients underwent PBMV using multi-track technique. All patients were subjected to full history and clinical examination, twelve leads surface electrocardiogram (ECG) before and after the procedure, two-dimensional and Doppler echocardiography, LV twist and untwist measured by the 2D the two-dimensional speckle tracking imaging (STI) before and after the procedure and PBMV. Results: In both techniques; the mitral valve area (MVA) was highly significantly increased after balloon mitral valvuloplasty (BMV), while mean pressure gradient (MPG) and the estimated systolic pulmonary artery pressure (PAP) were highly significantly decreased. The apical rotation, basal rotation, twist and untwist were highly significantly decreased after the procedure in each technique.