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.