Research Information System
AKDENİZ TIP DERGİSİ, vol.6, no.3, pp.364-374, 2020 (Peer-Reviewed Journal)
Objective: In moderate and severe mitral regurgitation (MSMR), left ventricular systolic dysfunction develops in time. We aimed to investigate the effect of mitral regurgitation on left ventricular mechanics as assessed with 2D strain echocardiography. We also sought to explore the correlation between BNP and severity of MR and also between BNP and LV mechanics. Material and Methods: Twenty four asymptomatic patients with organic MSMR were included. Left ventricular global longitudinal strain (LV-GLS), global circumferential strain and global radial strain were calculated and serum BNP was measured. Patients were divided into two groups according to their BNP value [≥140 pg/ml (group 1) and < 140 pg/ml(group 2)]. Results: Demographic data were similar in both groups. Group 1 had higher mitral E and A valve velocities (0.915±0.297 vs. 1.2±0.337, p=0.023 and 0.634±0.191 vs. 0.862±0.255, p=0,035 respectively). There was a significant difference in GLS values between group 1 and 2 (-20.159 ± 0.386 vs. -15.35±0.912, p<0.001, respectively). In correlation analysis, a positive correlation was found between GLS and BNP (r=0.814, p<0.001), BNP and regurgitant volume(r=0.681; p<0.001), BNP and ERO (r= 0.644, p=0.001). ROC analysis was performed and -18.07 was determined as the cut-off value for GLS that can help to categorize patients as low and high risk based on BNP values. Conclusion: We found that, in the absence of LV dilatation or reduced LV ejection fraction, GLS is reduced in asymptomatic organic MR and is well correlated with the BNP level. In asymptomatic patients with significant MR,s left ventricular global longitudinal strain and plasma BNP levels may be useful in determining subclinical dysfunction of the left ventricle for detecting high-risk patients who will benefit from early surgery.