Changes in ventricular structure and function after balloon mitral valvuloplasty : Magnetic resonance image follow-up study / Amir Anwar Shaker Samaan ; Supervised Wafaa Elaroussy , Karim Said , Magdi Habib Yacoub

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

Prior studies have showed abnormal left ventricular (LV) function in patients with rheumatic mitral stenosis (MS). The pattern of LV remodeling after balloon mitral valvuloplasty (BMV) has not been well elucidated. To describe changes in global and regional LV myocardial function in patients with rheumatic MS using CMR 6 months and one year after successful BMV. Thirty patients (median age 33 years, 22 women) with isolated rheumatic MS were studied. All patients had CMR before, 6 months and one year after successful BMV. The following parameters were studied: indexed LV end diastolic and end systolic volumes (LVEDVI and LVESVI respectively), ejection fraction (EF), LV torsion, and regional and global LV deformation (analyzed at 17 LV segments using myocardial tissue tagging). Late gadolinium enhancement was studied to look for any myocardial fibrosis. At baseline, patients had median EF of 57 (range: 45-69) %, LVEDVI of 74 (44-111) ml/m2 and LVESVI of 31 (14-57) ml/m2 with absence of late gadolinium enhancement in all myocardial segments. Six months following BMV, compared to pre-BMV study, all LV myocardial segments showed significant improvement in strain parameters with significant increase in global longitudinal LV peak systolic strain (-16.4 vs. -13.8, p<0.001), global circumferential peak systolic strain (-17.8 vs. -15.6, p=0.002), base-apex LV torsion (3.3{u00B0} vs. 2.5{u00B0} p<0.001) and base -mid LV torsion 3.6 vs. 2.3{u00B0} p<0.001

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