Assessment of subclinical left ventricular systolic function using strain imaging in the follow-up of patients with chronic mitral regurgitation

Abstract

Objective: Determining optimal timing for surgery in asymptomatic mitral regurgitation (MR) remains a challenge. The aim of this study was to evaluate subclinical changes in left ventricular (LV) systolic functions using velocity vector imaging (VVI) during follow-up of patients with chronic mitral regurgitation (MR). Methods: A total of 54 patients (mean age: 57.9 +/- 8 years; 55% male) with moderate-to-severe MR and normal LV ejection fraction (EF), and 30 healthy controls (mean age: 56 +/- 6.5 years; 55% male) were evaluated using conventional echocardiography and VVI at baseline. Results: At the end of 12 months, measurements of 45 MR patients were repeated. There was no significant change in LV dimensions or EF on follow-up. LV peak systolic strain and strain rate (SR) were decreased in patients with MR compared with controls (strain: 16.29 +/- 3.30 to 23.4 +/- 1.9; p=0.0001 and SR: 0.93 +/- 0.39 to 4.9 +/- 0.6; p=0.0001) at baseline. Impairment was more significant on follow-up. (strain: 13.76 +/- 2.68 and SR: 0.27 +/- 0.14; p=0.0001). Conclusion: VVI-derived strain imaging might be used in the assessment of subclinical LV dysfunction and its progression during follow-up of patients with chronic MR especially in the decision of optimal timing for surgery.