Presence of Paradoxical Mid-Systolic Longitudinal Strain (Stretching) with Speckle Tracking in the Basal Inferior-to-Lateral Segments in Mitral Valve Prolapse

Background and Purpose: Abnormality in the motion of the inferior papillary muscle was found in an early study of mitral valve prolapse (MVP). We visually observed an abnormal movement not only in the inferior wall but also in the anterolateral and inferolateral basal walls in several patients with MVP. Therefore, the aim of this work was to analyze these findings using strain (Speckle Tracking—STE).

Methods

A total of 60 MVP patients having a superior systolic displacement of the posterior leaflet, in whole or in part of the scallops, of at least 2 mm, and 20 normal subjects as controls were included. Longitudinal strain was calculated in the three apical views (Philips iE 33 Matrix—implemented strain software). The strain in the three abovementioned basal segments was measured at 160 msec from the beginning of systole (mid-systole), and then we averaged their values to form a “triad” of averaged values that could be subsequently compared among the groups for statistical calculations. The Global Longitudinal Strain (GLS) was also calculated for all subjects. The Mann–Whitney U-test was used for comparisons. A “p” value ≤ 0.05 was considered significant.