Prediction of subclinical left ventricular dysfunction with strain rate imaging in patients with mild to moderate rheumatic mitral stenosis.

BACKGROUND: Left ventricular (LV) long-axis function evaluated by Doppler tissue echocardiography-derived strain rate (SR) imaging has been shown to be a useful index of LV systolic function; however, it has not been evaluated in patients with mitral stenosis (MS). We examined the LV long-axis function of patients with pure MS and normal global systolic function as assessed by LV ejection fraction.
METHOD: In all, 30 patients (22 women; 45 +/- 9 years) with mild to moderate MS (mitral valve area = 1.5 +/- 0.3 cm2) and 28 healthy volunteers (20 women; 44 +/- 10 years) were evaluated by both conventional and Doppler tissue echocardiography. Two-dimensional Doppler tissue echocardiography was performed in the apical 4-chamber view in the septal and lateral wall on the mitral annular level. Peak systolic myocardial SR and end-systolic strain data were measured for both segments.
RESULTS: Peak systolic SR (1.2 +/- 0.4% vs 1.8 +/- 0.39%, P < .001) and end-systolic strain (10 +/- 5 vs 25 +/- 6 s(-1), P < .001) were both significantly lower in patients with MS than in control subjects.
CONCLUSIONS: Patients with MS had significantly impaired long-axis function evaluated by Doppler tissue echocardiography-derived SR imaging despite normal global systolic function.