Evaluation of the relationship between functional capacity and right ventricular diastolic function in patients with isolated mitral stenosis and sinus rhythm: a tissue Doppler study.

Aim: The right ventricular (RV) systolic function is an important determinant of clinical symptoms and exercise capacity in patients with mitral stenosis. No sufficient data are available concerning the effect of RV diastolic function on symptoms of patients with mitral stenosis. In the presence of normal RV systolic function, RV diastolic functions of asymptomatic patients with mitral stenosis of moderate or severe degree were compared to symptomatic ones by pulsed-wave tissue Doppler echocardiography in this study.

Materials And Methods: The study included 40 patients with mitral stenosis. Patients were classified into two groups according to New York Heart Association (NYHA) class (asymptomatic group NYHA class I, symptomatic group NYHA class II-III). RV diastolic functions were evaluated via pulsed-wave tissue Doppler in terms of isovolumic contraction time (IVCT), systolic wave velocity (S), isovolumic relaxation time (IVRT), early diastolic wave velocity (E'), and late diastolic wave velocity (A').

Results: Statistical difference was not determined in systolic parameters (S, IVCT) between the two groups. However, IVRT (54.21 +/- 11.93 msec vs 86.19 +/- 16.23 msec, P < 0.0001) and A' wave amplitude (10.16 +/- 2.14 cm/sec vs 13.55 +/- 3.35 cm/sec, P < 0.0001) were higher whereas E' wave amplitude (11.68 +/- 1.60 cm/sec and 10.25 +/- 2.73 cm/sec, P = 0.009) and E'/A' ratio (1.18 +/- 0.23 vs 0.76 +/- 0.17, P < 0.0001) were lower in group 2.

Conclusion: In isolated mitral stenosis, pulsed-wave tissue Doppler may be used for the detection of RV diastolic pathology. Diastolic functions of RV may deteriorate in the presence of normal systolic functions in symptomatic patients with isolated mitral stenosis.