Use of strain and strain rate echocardiographic imaging to predict the progression of mitral stenosis: a 5-year follow-up study

OBJECTIVE Little information is available about echocardiographic progression of mitral stenosis (MS). The aim of this study was to investigate whether the left ventricular (LV) strain is a favorable method predicting the progression of MS. METHODS Forty-eight patients with isolated mild-to-moderate MS were enrolled in this prospective cohort study. LV global longitudinal strain (GLS) and strain rate (GLSR) were measured by two-dimensional echocardiography (2-DE) at the baseline. Mitral valve area (MVA) was evaluated during the 5-year follow-up. The change in MVA from the beginning to the end of the surveillance period was determined as an indicator of progression. Pearson's correlation test was used, and significant differences between the groups were analyzed using the Student's t-test or the Mann-Whitney U test. At the end of follow-up, we evaluated the correlation between the change in MVA and both GLS-GLSR. GLS and GLSR are predictive factors for MS progression, whether or not it has been tested according to the receiver operating characteristics curve analysis. RESULTS A meaningful correlation was detected between the change in MVA with both GLS and GLSR (r=0.924 and r=0.980, respectively, p<0.001). The cut-off value for GLS was identified as -16.98 (sensitivity 81%, specificity 96%, p<0.001) and for GLSR as -1.45 (sensitivity 95%, specificity 100%, p<0.001). Patients with MS having a value under (mathematically above) these cut-off values showed more rapid progression. CONCLUSION The progression of MS can be predicted by GLS and GLSR measurements, which are evaluated via strain echocardiography.