22. Assessment of right ventricular longitudinal strain by speckle-tracking echocardiography in patients with severe mitral regurgitation due to valve prolapse
Main Article Content
Abstract
Mitral regurgitation due to valve prolapse is a common valvular heart disease and is becoming increasingly frequent. Recently, research has shown that right ventricular dysfunction is a factor related to prognosis in patients undergoing mitral valve surgery due to regurgitation. With the advancement of echocardiography, the technique of assessing right ventricular longitudinal strain by speckle-tracking echocardiography can detect early right ventricular dysfunction even when the patient has no clinical symptom and other routine echocardiographic parameters of right ventricular function are still within normal ranges. Our study was conducted to assess right ventricular global longitudinal strain (RVGLS) and right ventricular free wall longitudinal strain (RVFWS) by speckle-tracking echocardiography in patients with moderate to severe mitral regurgitation due to valve prolapse. The results showed that the mean RVGLS and RVFWS values of the study group were -18,9 ± 4.3% and -23.5 ± 5.4%, respectively. The rate of right ventricular dysfunction evaluated by conventional echocardiographic parameters (FAC, TAPSE, S’ tricuspid valve) was 12.0%, while it was increased to 34.3% when assessed based on right ventricular longitudinal strain using speckle-tracking echocardiography. Conclusion: RVGLS and RVFWS are capable of detecting early right ventricular dysfunction compared with conventional echocardiographic parameters in patients with moderate to severe mitral regurgitation due to valve prolapse.
Article Details
Keywords
Mitral regurgitation, mitral valve prolapse, longitudinal right ventricular strain, speckle-tracking echocardiography
References
2. Bohbot Y, Essayagh B, et al. Prognostic implications of right ventricular dysfunction in severe degenerative mitral regurgitation. J Am Heart Assoc. 2024 Dec 18. doi:10.1161/JAHA.124.036206.
3. Topilsky Y, Khanna AD, Oh JK, et al. Preoperative factors associated with adverse outcome after mitral valve repair. J Am Coll Cardiol. 2011; 58(4): 331-338. doi:10.1016/j.jacc.2011.03.034.
4. Kammerlander AA, Marzluf BA, Graf A, et al. Right ventricular dysfunction, but not tricuspid regurgitation, is associated with outcome late after left heart valve procedure. J Am Coll Cardiol. 2014; 64(24): 2633-2642. doi:10.1016/j.jacc.2014.09.062.
5. Rupi L, Donà C, De Bonis M, et al. Prognostic value of right ventricular longitudinal strain in patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair. JACC Cardiovasc Imaging. 2024; 17(1): 32-43. doi:10.1016/j.jcmg.2023.08.011.
6. Darweesh RM, Ahmed DMY, Ahmed KM, et al. Evaluation of right ventricular functions in patients with ischemic cardiomyopathy by speckle-tracking echocardiography. Egypt Heart J. 2024; 76(1): 132. doi:10.1186/s43044-024-00566-3.
7. Prihadi EA, van der Bijl P, Dietz M, Abou R, Vollema EM, Marsan NA, Delgado V, Bax JJ. Prognostic implications of right ventricular free wall longitudinal strain in patients with significant functional tricuspid regurgitation. Circ Cardiovasc Imaging. 2019; 12(3): e008666. doi:10.1161/CIRCIMAGING.118.008666.
8. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003
9. Normal range and usefulness of right ventricular systolic strain to detect subtle right ventricular systolic abnormalities in patients with heart failure: a multicentre study | European Heart Journal - Cardiovascular Imaging | Oxford Academic.AccessedNovember2, 2023.https://academic.oup.com/ehjcimaging/article/18/2/212/2937764.
10. Muraru D, Haugaa K, Donal E, et al. Right ventricular longitudinal strain in the clinical routine: a state-of-the-art review. Eur Heart J - Cardiovasc Imaging. 2022; 23(7): 898-912. doi:10.1093/ehjci/jeac022.
11. Badano LP, Kolias TJ, Muraru D, et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J - Cardiovasc Imaging. 2018; 19(6): 591-600. doi:10.109 3/ehjci/jey042.
12. Le Tourneau T, Deswarte G, Lamblin N, Foucher-Hossein C, Fayad G, Richardson M, et al. Right ventricular systolic function in organic mitral regurgitation: impact of biventricular impairment. Circulation. 2013; 127(15): 1597-1608. doi:10.1161/CIRCULATIONAHA.112.000999.
13. Hyllén S, Nozohoor S, Ingvarsson A, Meurling C, Wierup P, Sjögren J. Right ventricular performance after valve repair for chronic degenerative mitral regurgitation. Ann Thorac Surg. 2014; 98(6): 2023- 2030. doi:10.1016/j.athoracsur.2014.07.075.
14. Chikwe J, Itagaki S, Anyanwu A, Adams DH. Impact of Concomitant Tricuspid Annuloplasty on Tricuspid Regurgitation, Right Ventricular Function, and Pulmonary Artery Hypertension After Repair of Mitral Valve Prolapse. J Am Coll Cardiol. 2015; 65(18): 1931-1938. doi:10.1016/j.jacc.2015.01.059.
15. Nguyễn Tuấn Hải, Nguyễn Thị Minh Lý, Nguyễn Thị Thu Hoài, Phạm Nguyễn Vinh, Đỗ Doãn Lợi. Khuyến cáo về lượng giá chức năng tim bằng siêu âm ở người lớn trưởng thành: cập nhật từ Hội Siêu âm Tim Hoa Kỳ và Hội Hình ảnh Tim mạch Châu Âu.https://asecho.org/wp-content/uploads/2017/11/ChamberQuantification_VN.pdf, tr. 43-44.