Evaluation of the Effect of Percutaneous Mitral Balloon Valvuloplasty on Left Ventricular Systolic Function via Strain and Strain Rate in Patients with Isolated Rheumatic Mitral Stenosis

Abstract

Background and aim of the study: Percutaneous balloon mitral valvuloplasty (PMBV) has an established role in the treatment of rheumatic mitral stenosis. The study aim was to evaluate the effects of PMBV on left ventricular function in patients with rheumatic mitral stenosis (MS) by using strain and strain rate imaging modalities.

Methods: The study included 30 consecutive patients (21 women, nine men; mean age 44 +/- 14 years) with moderate to severe MS. Left ventricular long-axis strain and strain rate color tissue Doppler imaging of the septal, lateral, inferior and anterior basal segments were performed one day before and seven days after PMBV.

Results: Compared with pretreatment findings, lateral systolic strain (-13.4 +/- 2.9% versus -18.4 +/- 3.9%; p = 0.024), inferior systolic strain (-14.7 +/- 2.3% versus -17.6 +/- 2.1%; p = 0.016), anterior systolic strain (-15.2 +/- 2.4% versus -17.2 +/- 2.2%; p = 0.02), and septal systolic strain (-15.7 +/- 1.6% versus -18.1 +/- 1.9%; p = 0.018) values were significantly increased after the procedure, but no significant change was observed in strain rate analysis.

Conclusion: A rapid improvement in strain values after PMBV in patients with isolated MS showed that the LV systolic dysfunction in isolated MS is strongly associated with impaired hemodynamic parameters. Significantly increased strain values can be added to the criteria of successful PMBV.