Diastolic Dysfunction in Mitral Stenosis: Invasive Versus Noninvasive Methods

Evaluating left ventricular (LV) diastolic function in patients with severe mitral stenosis (MS), is challenging. This study aimed to assess the value of noninvasive imaging methods for detecting elevated LV end-diastolic pressure (LVEDP) in patients with MS, using invasive measurements as the reference. This study assessed diastolic function in 63 severe mitral stenosis patients undergoing Percutaneous Transluminal Mitral Commissurotomy using various echocardiographic techniques and invasive LVEDP measurements. The mean age of the patients was 49.9 ± 10.0 years, and 84.1% were women. In patients with atrial fibrillation and sinus rhythm, LVEDP was correlated with isovolumic relaxation time (IVRT), IVRT/T E-e’ , and diastolic strain rate. In addition, in patients with sinus rhythm, LVEDP was correlated with LV ejection fraction, LV global longitudinal strain, pulmonary vein diastolic deceleration time, and Myocardial Performance Index. IVRT, IVRT/T E-e’ , and diastolic strain rate were the best-performing parameters for assessing elevated LVEDP in patients with severe mitral stenosis. Noninvasive imaging parameters, especially IVRT, IVRT/TE-e’, and diastolic strain rate, effectively identify elevated LVEDP in patients with severe mitral stenosis.