Unmasking right ventricular dysfunction in chronic rheumatic mitral regurgitation

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Mechanics

Background:

• Right ventricular (RV) systolic function is crucial for mortality prediction but underexplored in chronic rheumatic mitral regurgitation (CRMR).
• Assessing RV function traditionally relies on parameters that may not detect early dysfunction.

Purpose of the Study:

• To investigate RV systolic function in patients with CRMR using speckle-tracking echocardiography (STE).
• To compare RV systolic function between CRMR patients and healthy controls.
• To identify predictors of RV dysfunction in CRMR.

Main Methods:

• A cross-sectional study involving 77 CRMR patients and 40 healthy controls.
• RV peak systolic strain (RVPSS) and left ventricular (LV) global longitudinal strain (GLS) measured via STE.
• Comparison of STE-derived parameters between groups and correlation with disease severity and LV function.

Main Results:

• RVPSS was significantly lower in CRMR patients compared to controls (-16.8 ± 4.5% vs -19.2 ± 3.4%, p=0.003).
• RVPSS reduction was more pronounced in severe CRMR and in patients with LV systolic dysfunction.
• LVGLS and significant tricuspid regurgitation (TR) independently predicted RVPSS (p<0.001).

Conclusions:

• Speckle-tracking echocardiography-derived RVPSS is a sensitive marker for detecting early RV systolic dysfunction in CRMR.
• Traditional RV function parameters were less sensitive in identifying early RV impairment in this cohort.