ASSESSMENT OF LEFT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH MITRAL AND AORTIC VALVE DISEASE USING GLOBAL LONGITUDINAL STRAIN ECHOCARDIOGRAPHY

Abstract

Introduction:Left ventricular global longitudinal strain is widely recognized as a more sensitive measure of LV systolic function compared with LV ejection fraction (LVEF). In addition, the measurement of LVGLS is more reproducible than two-dimensional LVEF. Current guidelines for diagnosis and treatment of valvular heart disease include LVEF as one of the parameters to take into consideration in the clinical decision-making.
Assessment of left ventricular systolic function in patients with aortic and mitral valve heart disease is often reliant on quantification of LV ejection fraction to determine the optimal timing for surgery, evaluate operative risk, and prognostic outcome.
Aim and Objectives:A prospective observational study, to calculate Left Ventricular Global Longitudinal Strain using strain echocardiography to assess LV systolic function in patients with aortic and mitral valve disease
Materialsand Methods:A total of 350 patients with moderate and severe aortic and mitral valve disease(MS,MR,AS,AR) are considered in this study. All 350 patients were found to have preserved Ejection fraction while assessing by 2-dimensional echocardiography using SIMPSON’Smethod.
All standard apical 4 chamber, 2 chamber and 3 chamber were recorded for the 350 patients to measure the global longitudinal strain, in order to detect Subclinical Myocardial dysfunction.
Results:
Out of 350 patients, 258 patients had rheumatic heart disease(MS,MR,AS,AR) , 92 patients had degenerative heart disease. 177(68.6%) out of 258 patients with Rheumatic Heart disease had reduced GLS. 61(66%) out of 92 patients with Degenerative Heart Disease had reduced GLS.
Conclusion:
Left Ventricular Global Longitudinal Strain shows a modest correlation with valvulo - arterial impedance. LVGLS is increasingly used to identify subclinical myocardial dysfunction in patients with valvular heart disease and optimal timing for surgery and prognosticate outcomes after surgery.