Right ventricular speckle tracking analysis in patients with mitral stenosis

Abstract

The 2D-speckle tracking is a new echocardiographic tool to have an objective and angle-independent quantification of myocardial deformation. Recent developments were performed for the quantification of longitudinal dynamic right ventricular deformation. We aimed to evaluate the role of two-dimensional (2D) strain imaging in the assessment of subclinical RV dysfunction. Fifty patients with rheumatic mitral stenosis (MS group) and 20 control healthy patients were recruited and had had standard echocardiography and Doppler echocardiography. The right ventricular functions were determined by conventional methods and two-dimensional (2D) longitudinal strain. There were no significant differences in age, sex, Body mass index and Left ventricular ejection fraction. Mitral valve area in MS group (1.38 ± 0.5 cm vs. 3 ± 0 cm), left atrial surface (31.68 ± 8.5 cm 2 vs. 13.5 ± 1.4 cm 2 ), and Pulmonary systolic arterial pression (44.64 ± 12.4 mmHg vs. 22.7 ± 2.7 mmHg) were higher in MS group. Conventional echocardiographic modalities of RV function were analysed: Peak systolic velocity at the lateral tricuspid annulus (S’: 12.24 ± 2.8 cm/s vs. 18.6 ± 1 cm/s) and tricuspid annular systolic excursion (TAPSE) were lower in MS group (18.7 ± 4.07 vs. 26.7 ± 0.7). Two-dimensional longitudinal strain was significantly decreased in MS group (−14.1 ± 4.2 vs. −19.3 ± 1.6) and was correlated to mitral valve area ( P = 0.03). There was a correlation between conventional methods (S’ and TAPSE) and RV-strain (RV-strain- S’: P = 0.001; RV strain-TAPSE: P = 0.01). We demonstrated that patients with MS had lower RV functions using 2D strain imaging. 2D strain imaging appears to be useful in the detection of subclinical RV dysfunction in patients with MS.