VALUE OF 3D SPECKLE TRACKING ECHOCARDIOGRAPHY IN ASSESSMENT OF LEFT VENTRICULAR SYSTOLIC MECHANICS BEFORE AND AFTER MITRAL VALVE REPLACEMENTIN PATIENTS WITH SEVERE PRIMARY MITRAL REGURGITATION

Abstract

Background: The mitral valve repair or replacement is indicated for patients with symptomatic mitral incompetence. When operative treatment is being considered, the chronic and often slowly but relentlessly progressive nature of MR must be weighed against the immediate risks and long-term uncertainties attendant onsurgery, especially if mitral valve replacement (MVR) is required. Objectives: Tostudy and assess the left ventricular function in patients with mitral valve incompetence before and after mitral replacement. By real-time 3-dimensional (3D) speckle tracking echocardiography (RT3D-STE). Patients and methods: The ethical approval was obtained from the hospital ethical research committee and each patient entering the study signed an informed consent. The study involved 40 patient with severe primary mitral regurgitation collected from the Cardiology clinic of Al-Azhar University Hospitals. The patients were screened for the study enrolment prospectively. The study was performed at Islamic cardiac center of cardiology, Al-Azhar University at the period from June 2019 to April 2020.Detailed history, physical examination, resting ECG, conventional 2D echocardiography assessment, strain imaging with measurement of LV-GLS 2D speckle tracking and RT3D-STE (Left ventricular ejection fraction (LVEF), and global longitudinal, area, radial, and circumferential strain (GLS, GAS, GRS, and GCS). Results: Real time 3D speckle tracking echocardiography was an echocardiographic modality that could detect early and subtle LV dysfunction in patients with mitral regurgitation. Conclusion: Real time 3D speckle tracking echocardiography could detect early and subtle LV dysfunction in patients with mitral regurgitation and could predict prognosis of the patient and determine the time of surgery in which the patient could get the most value. Abbreviation: MVR: mitral valve replacement, LV: left ventricle, GLS: global longitudinal strain, GAS: global area strain, GCS: global circumferential strain, GRS: global radial strain