Distribution, Etiology and Myocardial deformation imaging by speckle-tracking echocardiography in Valvular heart disease: A sub-analysis from a Clinical Registry

Abstract Purpose Valvular Heart Disease (VHD) has been a major contributor of global cardiovascular morbidity and mortality with increasing need of percutaneous/surgical cardiac intervention. Strain echocardiography has been widely recognizable tool to guide the timings of interventions in these patients. The purpose of this study was to document the demographic, clinical signs and symptoms, Electrocardiographic and Echocardiographic parameters in different groups of VHD as well as to assess Left ventricular and right ventricular function in specific groups of VHD. Methods All patients with valvular heart disease who visited a tertiary care hospital in Karnataka during the study period were included in the registry. However, for the study purpose VHD with a severity of at least more than or equal to moderate and with preserved Left ventricle ejection fraction (LV EF) were included for the analysis. Basic demographic, clinical, electrocardiographic, standard echocardiographic and strain parameters were obtained and evaluated. Results During the study period of 10 month a total number of 5,271 subjects had VHD (excluding the presence of trivial or mild functional regurgitant lesion). The most commonly occurring single valvular disease was mitral regurgitation (31%) followed by aortic stenosis (15%) and aortic regurgitation (13%). Rheumatic heart disease (RHD) was the dominant etiology (32.8%) for VHD followed by degenerative heart disease (31.3%). Deformation imaging by 2D speckle-tracking echocardiography was preserved for left ventricle (LV) but mildly reduced for right ventricle (RV). Conclusion MR was the most common valvular lesion followed by AS and AR. Rheumatic disease still prevails as the major precursor. Ventricular remodelling varied depending on the lesion type.