Distribution, Etiology and Myocardial Deformation Imaging by Speckle-tracking Echocardiography in Valvular Heart Disease with Preserved Ejection Fraction: A Sub-analysis from a Clinical Registry
Sridevi Prabhu, Krishnananda Nayak, Monika Jawanjal, Manjoosha Moodukudru, M. Swathi Poojary, K.S Rashmi, Asmitha G. Nayak, A J AshwalBackground:
Valvular heart disease (VHD) is a major contributor to global cardiovascular morbidity and mortality, with a growing need for percutaneous and surgical cardiac interventions. Speckle-tracking echocardiography (STE)-derived strain imaging has emerged as a validated tool to guide the optimal timing of intervention in these patients. This study aimed to describe the demographic, clinical, electrocardiographic (ECG), and echocardiographic characteristics across VHD subtypes and to assess biventricular myocardial deformation using STE.
Methods:
This study included patients with moderate or severe VHD and preserved left ventricular (LV) ejection fraction (>55%). VHD was classified by etiology, type, and severity. Standard transthoracic echocardiography was used to assess left and right ventricular (RV) function. Myocardial deformation was analyzed using STE. Data on demographics, clinical status, and ECG were recorded systematically to evaluate ventricular remodeling patterns.
Results:
During the study period of 10 months, a total of 5271 patients had VHD. The most common single valvular lesion was mitral regurgitation (MR) (31%), followed by aortic stenosis (AS) (15%) and aortic regurgitation (AR) (13%). Rheumatic heart disease was the dominant etiology (32.8%), followed by degenerative heart disease (31.3%). LV global longitudinal strain (LV-GLS) was preserved overall, whereas RV-GLS was mildly impaired.
Conclusion:
MR was the most common valvular lesion, followed by AS and AR. Rheumatic heart disease remains the predominant etiological contributor. Ventricular remodeling patterns varied by lesion type, with strain imaging detecting subclinical dysfunction despite preserved ejection fraction.