الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Rheumatic MS is one of the most common diseases in the developing countries and it has many complications. MS needs proper assessment in order to determine the best method of management whether medical or interventional. Because it is an obstructive disease, the only definitive therapy is mechanical relief of this obstruction. These are PMBV, open commisurotorpy and mitral valve replacement.
Measurements of left ventricular (LV) function are important for estimating prognosis and guiding the management of patients with multiple forms of cardiac disease.
In our study, we aimed to uncover the incidence of LV systolic dysfunction in patients with predominant rheumatic mitral stenosis.
One hundred patients with rheumatic MS were evaluated and compared with 30 healthy individuals as a control group. We excluded any patient with any obvious cause affecting LV systolic function (Significant MR, other valve affection, cardiomyopathies, hypertension, diabetes and coronary artery disease). All subjects were assessed by 2D and speckle tracking echocardiography.
Both global basal and mid segment strain were significantly lower in patients with MS despite normal LV dimension and systolic function. Moreover, the segmental strain of all basal and mid segments was significantly lower in MS patients. However, there was no significant statistical difference regarding global apical strain.
There was a significant negative correlation between mean transmitral pressure gradient and basal longitudinal strain, mid longitudinal strain, and a significant correlation apical longitudinal strain.
Conclusion and recommendations
● Conclusion
In conclusion, when compared with healthy subjects, patients with MS had lower LV functions using 2D strain analysis, and this was independent of the hemodynamic severity of the obstruction. The most probable reason for this finding is rheumatic myocardial involvement or so-called myocardial factor. In the detection of subclinical LV dysfunction in patients with MS, 2D strain imaging appears to be useful.
● Recommendation
Assessment of LV strain in patients with rheumatic MS is beneficial and more important than LVEF. Therefore, it should be included in the assessment of those patients to detect subclinical myocardial dysfunction.