Assessment Of Right Ventricular Function In Rheumatic Mitral Stenosis Using Transthoracic Real-Time Three-Dimensional Echocardiography

Objective: To quantitatively evaluate right ventricular (RV) volume and function in patients with rheumatic mitral stenosis (RMS) by real-time three-dimensional echocardiography (RT-3DE).Methods: Forty-six patients of RMS with mild (n=16), moderate (n=13) and severe (n=17) stenosis were examined by RT-3DE. Sixteen age-matched healthy adults in sinus rhythm, with normal electrocardiogram and routine echocardiogram, served as controls. The right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) were measured and the right ventricular ejection fraction (RVEF) was calculated.Results: RVEDV was not significantly different between patients with mild stenosis and healthy controls (P>0.05), but there was significant difference between patients with moderate (P<0.05) or severe (P<0.01) stenosis and healthy controls. RVESV of patients with mild or moderate (P<0.05), or severe (P<0.01) stenosis was significantly greater than that of controls. RVEF was significantly smaller in all the patients compared with healthy controls (P<0.01). Furthermore, RVEDV of patients with severe stenosis was significantly greater than that of mild stenosis (P<0.05). RVEF was also significantly different between patients with mild and severe stenosis (P<0.01).Conclusions: RV function is impaired earlier than LV function in patients with RMS. They, especially those with moderate or severe stenosis, have a higher RV volume and lower RV function compared with healthy persons. RT-3DE can accurately evaluate RV function.