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Evaluation of Right Ventricular Function in Patients with Severe and Very Severe Mitral Stenosis
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  • Leila Bigdelu,
  • Morteza Boskabady,
  • Kasra Molooghi,
  • Leila Amirbeik,
  • Maliheh Dadgarmoghaddam,
  • Ali Azari
Leila Bigdelu
Mashhad University of Medical Sciences
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Morteza Boskabady
Mashhad University of Medical Sciences
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Kasra Molooghi
Mashhad University of Medical Sciences
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Leila Amirbeik
Mashhad University of Medical Sciences
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Maliheh Dadgarmoghaddam
Mashhad University of Medical Sciences
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Ali Azari
Mashhad University of Medical Sciences
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Abstract

Background: Right Ventricular (RV) failure has a critical role in the onset and progression of clinical symptoms and the prognosis of patients with Mitral Stenosis (MS), but the exact role, effect, and pathophysiology of RV dysfunction in MS is still controversial. In this study, we aimed to evaluate echocardiographic signs of systolic RV dysfunction using Tissue Doppler Imaging (TDI) and Velocity Vector Imaging (VVI) in subjects with severe and very severe MS. Methods: 46 isolated MS cases (23 severe and 23 very severe) and 23 healthy controls were enrolled in this study. RV function was assessed by tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and peak systolic velocity of the tricuspid annulus (S’) using TDI, and RV free wall strain (RVFWS) employing VVI. Furthermore, these values were compared with mitral valve area (MVA) and pulmonary arterial pressure (PAP). Results: TAPSE, FAC, S’, and RVFWS values were substantially declined in MS cases compared with healthy controls. Moreover, PAP values were considerably increased in MS subjects. Additionally, S’ and TAPSE values were significantly lower in very severe MS patients compared with severe patients. Conclusion: RV systolic function deteriorates in patients with severe and very severe MS. It appears that the degree of the severity of MS can proportionately affect the extent of RV dysfunction and some of its echocardiographic markers such as S’ and TAPSE. TDI and VVI can be used as practical early diagnostic methods for RV dysfunction in MS.