Changes of left ventricle function and mechanics in rheumatic mitral stenosis patients

Jessica Theodorie1, Ignė Urbonavičiūtė1*, Gintarė Martinkutė2, Eglė Ereminienė2

1Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

2Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania



Background: The correlation between rheumatic mitral valve (MV) alterations and left ventricle (LV) geometry and function has been controversial.

Aim: The aim of this prospective study was to establish changes of LV using 2D echocardiography (2DE) and two dimensional speckle tracking imaging (2DSTI).

Methods: 2DE was performed in 22 patients with mitral stenosis and 23 controls. Clinical data (NYHA functional class, coexisting diseases, medical treatment) were collected. MV area, LV end-diastolic diameter, indices of LV end-diastolic and systolic volume, LV ejection fraction (EF), diameter of left atrium (LA), LA volume, pulmonary artery systolic pressure were evaluated. LV global longitudinal strain (GLS) was assessed by 2DSTI. Parameters were analyzed by SPSS software.

Results: Reduced LV EF and LV GLS was found in MS patients (p<0.001), while LV diastolic diameter and volume index did not differ between groups (p=0.6 and p=0.84). The correlation between MV area and LV GLS, LA volume and the velocity of TV regurgitation was revealed. The smaller MV area (<1,4 cm2) correlated with lower LV GLS (r=-0.436, p=0.042), lower LV EF (r=0.533, p=0.01), more dilated LA (p=0,025) and higher TV regurgitation velocity (r=-0,579, p=0,005). There was no significant correlation found between MV area and LV end diastolic diameters and volumes (p=0.2 and p=0.3), as well as RV diameter and RV longitudinal function parameters.

Conclusions: LV GLS and LV EF was lower in rheumatic MS group patients when compared to control group and was related to the severity of valve stenosis.

Keywords: rheumatic mitral stenosis; left ventricle function; two dimensional speckle tracking imaging; left ventricle global longitudinal strain;