Abstract
Background and objectives. Mitral regurgitation (MR) is usually dynamic and increasing with exertion. Stress may provoke symptoms, cause the progression of pulmonary hypertension (PH) and unmask subclinical changes of the left and right ventricle function. The aim of this study was to evaluate changes of right ventricle (RV) functional parameters during stress and to find out determinants of RV function in patients with MR. Materials and methods. We performed a prospective study that included patients with asymptomatic primary moderate to severe MR and preserved left ventricular (LV) ejection fraction (EF) at rest (≥60%). Conventional 2D echocardiography at rest and during stress (bicycle ergometry) and offline speckle tracking analysis were performed. Results. 80 patients were included as MR (50) and control (30) groups. Conventional functional and myocardial deformation parameters of RV were similar in both groups at all stages of exercise (p > 0.05). The grade of MR (p = 0.004) and higher LV global longitudinal strain (p = 0.037) contributed significantly to the changes of tricuspid annular plane systolic excursion (TAPSE) from rest to peak stress. Changes of MR ERA from the rest to peak stress were related to RV free wall longitudinal strain (FWLS) and four chambers longitudinal stain (4CLS) at rest (p = 0.011; r = −0.459 and p = 0.001; r = −0.572, respectively). Significant correlations between LV EF, stroke volume, cardiac output and RV fractional area change, S′, TAPSE, FWLS, 4CLS were obtained. However, systolic pulmonary artery pressure and RV functional, deformation parameters were not related (p > 0.05). Conclusions. Functional parameters of LV during exercise and severity of MR were significant determinants of RV function while PH has no correlation with it in patients with primary asymptomatic moderate to severe MR.
Highlights
Mitral regurgitation (MR) is one of the most common valvular heart diseases [1]
We found higher systolic pulmonary artery pressure (PAP) during stress in patients with primary heart catheterization [28,29]; transthoracic echocardiography helps to evaluate a level of asymptomatic moderate to severe MR than in controls, while at rest, the difference was not significant
We demonstrated that in MR group significantly higher S0, fractional area change (FAC) and right ventricle (RV) longitudinal strain during stress were obtained in patients with higher left ventricular (LV) Stroke volume (SV) and Cardiac output (CO)
Summary
Severe MR leads to volume overload of the left ventricle (LV) and left atrium (LA), causes progression of postcapillary pulmonary hypertension (PH) and heart failure [2,3]. The severity of MR is usually dynamic and increasing with exertion [5]. Cause the progression of PH and unmask subclinical changes of the LV and right ventricle (RV) function [6]. Mitral regurgitation (MR) is usually dynamic and increasing with exertion. Cause the progression of pulmonary hypertension (PH) and unmask subclinical changes of the left and right ventricle function. We performed a prospective study that included patients with asymptomatic primary moderate to severe MR and preserved left ventricular (LV) ejection fraction (EF) at rest (≥60%). Conventional 2D echocardiography at rest and during stress (bicycle ergometry) and offline speckle tracking analysis were performed
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
