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Two-Dimensional Longitudinal Strain and Strain Rate Imaging for Assessing the Right Ventricular Function in Patients with Mitral Stenosis


Address for correspondence and reprint requests: Aydan Ongun Ozdemir, M.D., 31 Sokak 5/12 Bahcelievler, 06490, Ankara/Turkey. Fax: +90 312 312 52 51; E-mail:


Background: Longitudinal two-dimensional strain (L2DS) deformation is a novel technique that evaluates global and regional right ventricular (RV) function. The aim of the study was to investigate the systolic function of RV by using this method in patients with pure mitral stenosis (MS). Methods: Conventional echocardiography and L2DS analysis were performed in 45 MS patients and 21 healthy controls. For strain analysis apical four-chamber views were obtained and by using a software system, peak systolic strain and strain rates were calculated off-line in each segment. Results: The mean global longitudinal strain (GLS) of the whole RV (−20 ± 7 vs. −24 ± 6%, P= 0.02) and mean GLS of the septum (−19 ± 7 vs. −23 ± 5%, P = 0.03) were significantly reduced in the MS patients. Compared with the control group no significant change was determined in the mean GLS of the RV free wall (RVFW). While the mean global longitudinal strain rates (GLSR) of the entire RV and RVFW were similar between the groups, a significant difference in the mean GLSR of the septum (−1.2 ± 0.4 vs. −1.5 ± 0.3 s−1, P= 0.005) was determined in the patients with MS. A regional analysis demonstrated that MS patients had significantly reduced strain and strain rates in the basal and mid-segments of the septum, whereas only lower strain values in the basal RVFW. Conclusions: RV systolic function evaluated by L2DS analysis in patients with MS has shown decreased global and segmental systolic functions. (ECHOCARDIOGRAPHY 2010;27:525-533)