Left ventricular mechanics before and after mitral valve replacement in patients with severe mitral regurgitation

Abstract

Objectives To study left ventricular (LV) mechanics in patients with severe mitral valve regurgitation (MR) before and after mitral valve replacement (MVR). Background Our study investigated the short-term follow-up of LV deformation mechanics twist and untwist and LV-global longitudinal strain as an LV function parameter affected by MVR in patients presented with severe mitral regurgitation. Patients and methods We assessed LV deformations by Speckle-tracking echocardiography in 30 patients who had preserved LV ejection fraction before, 1 week after, and 3 months after MVR surgery. Results Among the study population, 16 were men and the mean age was 54.9 ± 6.9 years. There was a significant decrease in LV ejection fraction, LV dimensions, and volumes during early follow-up, which recovered at 3-month follow-up. Right ventricular basal dimension, right ventricular systolic pressure, grade of tricuspid regurgitation, and functional capacity were significantly improved. There was significant deterioration of global longitudinal strain in the early postoperative period; however, it was improved 3 months later (P1 < 0.001, P2 < 0.001, and P3 < 0.001). There was a significant decrease regarding twist between preoperative, early, and late postoperative periods (P1 < 0.001, P2 < 0.001, and P3 < 0.001). There was a significant improvement regarding the untwist rate between preoperative and late postoperative periods (−103 ± 15.3 vs. −122.4 ± 15.3, P2 < 0.001). Conclusions In patients with severe MR, Speckle tracking is a useful technique for assessing LV deformation mechanics and detect subtle affection before conventional echocardiography.