Samaan Amir Anwar, Said Karim, Aroussy Wafaa El, Hassan Mohammed, Romeih Soha, El Sawy Amr, Fawzy Mohammed Eid, Yacoub Magdi
Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
Magdi Yacoub Heart Foundation-Aswan Heart Centre, Cairo, Egypt.
Front Cardiovasc Med. 2021 Jun 4;8:674435. doi: 10.3389/fcvm.2021.674435. eCollection 2021.
Rheumatic heart disease affects primarily cardiac valves, it could involve the myocardium either primarily or secondary to heart valve affection. The influence of balloon mitral valvuloplasty (BMV) on left ventricular function has not been sufficiently studied. To determine the influence of balloon mitral valvuloplasty (BMV) on both global and regional left ventricular (LV) function. Thirty patients with isolated rheumatic mitral stenosis (MS) were studied. All patients had cardiac magnetic resonance imaging (CMR) before, 6 months and 1 year after successful BMV. LV volumes, ejection fraction (EF), regional and global LV deformation, and LV late gadolinium enhancement were evaluated. At baseline, patients had median EF of 57 (range: 45-69) %, LVEDVI of 74 (44-111) ml/m and LVESVI of 31 (14-57) ml/m with absence of late gadolinium enhancement in all myocardial segments. Six months following BMV, there was a significant increase in LV peak systolic global longitudinal strain (GLS) (-16.4 vs. -13.8, < 0.001) and global circumferential strain (GCS) (-17.8 vs. -15.6, = 0.002). At 1 year, there was a trend towards decrease in LVESVI (29 ml/m, = 0.079) with a significant increase in LV EF (62%, < 0.001). A further significant increase, compared to 6 months follow up studies, was noticed in GLS (-17.9 vs. -16.4, = 0.008) and GCS (-19.4 vs. -17.8 = 0.03). Successful BMV is associated with improvement in global and regional LV systolic strain which continues for up to 1 year after the procedure.
风湿性心脏病主要影响心脏瓣膜，也可能原发性累及心肌或继发于心脏瓣膜病变。球囊二尖瓣成形术（BMV）对左心室功能的影响尚未得到充分研究。为了确定球囊二尖瓣成形术（BMV）对左心室整体和局部功能的影响。对30例孤立性风湿性二尖瓣狭窄（MS）患者进行了研究。所有患者在成功进行BMV之前、术后6个月和1年都接受了心脏磁共振成像（CMR）检查。评估左心室容积、射血分数（EF）、左心室局部和整体变形以及左心室延迟钆增强情况。基线时，患者的EF中位数为57（范围：45 - 69）%，左心室舒张末期容积指数（LVEDVI）为74（44 - 111）ml/m²，左心室收缩末期容积指数（LVESVI）为31（14 - 57）ml/m²，所有心肌节段均无延迟钆增强。BMV术后6个月，左心室整体峰值收缩期纵向应变（GLS）显著增加（-16.4对-13.8，P<0.001），整体圆周应变（GCS）也显著增加（-17.8对-15.6，P = 0.002）。在1年时，LVESVI有下降趋势（29 ml/m²，P = 0.079），左心室EF显著增加（62%，P<0.001）。与术后6个月的随访研究相比，GLS（-17.9对-16.4，P = 0.008）和GCS（-19.4对-17.8，P = 0.03）进一步显著增加。成功的BMV与左心室整体和局部收缩期应变的改善相关，这种改善在术后长达1年的时间里持续存在。
