Immediate and short-term outcomes of percutaneous transvenous mitral commissurotomy on global and regional right ventricular strain by speckle-tracking echocardiography

Abstract

Objectives: The study aimed to determine short- and long-term improvement on global and regional right ventricular (RV) strain after successful treatment by percutaneous transvenous mitral commissurotomy (PTMC). Furthermore, we endeavored to define the normal values of RV strain in a healthy age- and sex-matched population that may serve as reference for future investigators. Methods: The interventional case–control study was done on consecutive patients who were admitted in the department of cardiology for balloon mitral valvotomy (BMV) from April 2018 to July 2019. One hundred and forty-eight patients with isolated severe mitral stenosis (MS) in sinus rhythm were assessed for RV function by two-dimensional speckle tracking calculating RV global longitudinal strain (GLS-RV) and longitudinal strain of the free wall (GLS-RVFW) before and after BMV and compared with seventy-two healthy age-matched controls for a 6-month follow-up. Results: At baseline, the GLS of the right ventricle and free wall strain was significantly less among cases as compared to controls (GLS-RV median 20 vs. 23.3, P < 0.0001 and GLS-RVFW median 23 vs. 27, P < 0.0001). Post-PTMC, the global and regional longitudinal RV strain improved significantly at 24 h and 6 months post procedure and became comparable to that of the control population at 6-month follow-up (cases vs. controls: median GLS-RV [23 vs. 23.3, P = 0.774] and GLS-RVFW [27 vs. 27, P = 0.558]). Conclusions: PTMC causes significant immediate and long-term improvement in the RV strain and can serve as a good prognostic marker for the outcomes in patients with isolated MS.

Keywords

• free wall right ventricular strain
• global right ventricular strain
• mitral stenosis