Introduction
Rheumatic mitral stenosis is a leading cause of morbidity in developing
countries. It has adverse hemodynamic effects on both pulmonary
circulation and left atrium that may not be completely determined by
conventional transthoracic echocardiographic techniques. Symptomatic
patients with mitral valve area>1.5 cm2comprises a gray zone in management. Therefore, exercise stress testing
is recommended in these patients with symptoms discordant with the
severity of the stenosis. Left atrial strain analysis with speckle
tracking imaging emerges as a promising technique for the evaluation of
these hemodynamic effects better. Despite the well-known fact that the
left ventricle is spared from the deleterious hemodynamic effects of
mitral stenosis, some new research has recently revealed that it might
actually be associated with sub-clinical left ventricle dysfunction. The
aim of our study is to examine the left atrial and ventricular function
both during rest and just after exercise by speckle tracking imaging in
patients with mild rheumatic mitral stenosis and ascertain early
hemodynamic deterioration.