الفهرس 
Mitral StenosisOnly 14 pages are availabe for public view
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Abstract
Rheumatic heart disease is considered the second most common cause of cardiovascular morbidity and mortality after atherosclerotic vascular disease, particularly in developing countries. Mitral stenosis is the most common valve lesion in chronic RHD. Several mechanisms have been postulated to explain left ventricular systolic dysfunction in patients with mitral stenosis, however, there is a controversy regarding the mechanism and the degree of LV affection.
CMR tissue tagging is a powerful non-invasive diagnostic tool for quantifying regional systolic and diastolic myocardial function. Owing to the inherent features of CMR tissue characterization and its multi-planar capabilities, CMR tagging is able to reveal previously undetected components of regional myocardial mechanical function and, thus, aid in the early detection and management of a wide range of myocardial disease processes. Moreover, ongoing developments in the technology, imaging techniques, and analytical tools used to implement CMR tagging will likely further advance current capabilities for performing sophisticated analyses of regional myocardial function. As such, myocardial tagging promises to continue to enhance our understanding of the mechanical complexities underlying the function of the normal and abnormal myocardium.
The aim of our study was to evaluate the change in the global and regional left ventricular systolic function before and after percutaneous balloon mitral valvotomy using cardiac magnetic resonance imaging for patients with rheumatic mitral stenosis.
This study included 20 patients with severe rheumatic mitral stenosis, presented to Ain Shams University hospitals in the time period from August 2016 to March 2017.
Patients who were eligible to PBMV according to 2012 European society of Cardiology valvular heart diseases guidelines, went through history taking, detailed physical examination, 12 leads electrocardiography, chest x-ray, trans-thoracic echocardiography, trans-oesophageal echocardiography and cardiac MRI prior to percutaneaous balloon mitral valvuloplasty (PBMV).
Follow up was done after 2 months, by assessment of clinical status, physical examination, trans-thoracic echocardiography and cardiac MRI with same protocol of pre PBMV study.
Comparing post PBMV with pre PBMV revealed significant echocardiographic results. Ejection fraction improved significantly following PBMV, also we recorded a significant DROP of pulmonary artery pressure and a significant increase in mitral valve area.
In our study, we applied recent technological modalities in CMR, like myocardial tagging and CURE index. We aimed at identifying the regional and global LV dysfunction with the most accurate modalities available.
Using CMR, we concluded a significant increase in EF post PBMV. We also concluded a significant improvement in global circumferential strain comparing post PBMV values with pre PBMV values. Regarding regional circumferential strain, we concluded a significant improvement following PBMV specifically at basal infero-lateral and apical inferior segments.