Subclinical right ventricular dysfunction in patients with mitral stenosis.

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Physiology

Background:

• Right ventricular (RV) dysfunction is a significant predictor of adverse outcomes in patients with mitral stenosis (MS).
• Early detection of subclinical RV dysfunction is crucial for managing MS patients.

Purpose of the Study:

• To investigate the presence of subclinical right ventricular dysfunction in asymptomatic patients with mitral stenosis.
• To compare RV function parameters between MS patients and healthy controls using echocardiography.

Main Methods:

• A prospective study involving 104 asymptomatic MS patients and 52 healthy controls.
• Standard and speckle tracking echocardiography were utilized to assess various RV function parameters.
• Measurements included RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), and RV myocardial performance index (MPI).

Main Results:

• Asymptomatic MS patients exhibited decreased RVFAC, TAPSE, MPI, and peak systolic velocity (S') compared to controls, despite normal ranges.
• Global RV longitudinal strain (LSGRV) and free wall longitudinal strain (LSFRV) were significantly lower in MS patients.
• Over 50% of MS patients showed LSFRV below -20%, indicating significant longitudinal strain impairment.

Conclusions:

• The study confirms the presence of subclinical systolic dysfunction of the right ventricle in patients with mitral stenosis.
• These findings highlight the utility of echocardiographic parameters, particularly longitudinal strain, in identifying early RV impairment in MS.