{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:57:59Z","timestamp":1760029079989,"version":"3.37.3"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,2]]},"abstract":"Objective<\/jats:title>We aimed to investigate the utility of right ventricular (RV) dyssynchrony to assess functional capacity utilizing 6\u2010minute walking test distance (6MWTD<\/jats:styled-content>) and to measure brain natriuretic peptide levels (BNP<\/jats:styled-content>) in patients with mitral stenosis (MS) and to study its value to predict adverse outcome following percutaneous balloon mitral valvuloplasty (PBMV<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 108 patients with moderate to severe MS<\/jats:styled-content> (26.5\u00a0\u00b1\u00a07.5\u00a0years) were included in this study. All were candidates for PBMV<\/jats:styled-content>. RV<\/jats:styled-content> strain curves were obtained using two\u2010dimensional speckle\u2010tracking echocardiography, and standard deviation (SD<\/jats:styled-content>) of 4 segments without RV<\/jats:styled-content> apex (\u2010SD4) was also assessed. 6MWT and BNP<\/jats:styled-content> were before and after 12\u00a0months following PBMV<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>RV<\/jats:styled-content>\u2010SD<\/jats:styled-content>4 was significantly prolonged in patients with MS<\/jats:styled-content> compared with controls (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001). Patients with 6MWTD<\/jats:styled-content> \u2264300\u00a0m had a significantly increased RV<\/jats:styled-content>\u2010SD<\/jats:styled-content>4 (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001) and had higher BNP<\/jats:styled-content> values (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.03) compared with those with 6MWTD<\/jats:styled-content> >300\u00a0m. RV<\/jats:styled-content>\u2010SD<\/jats:styled-content>4 showed a strong correlation with 6MWT<\/jats:styled-content> and BNP<\/jats:styled-content> level. RV<\/jats:styled-content>\u2010SD<\/jats:styled-content>4 was the strongest independent predictor of adverse outcome following PBMV<\/jats:styled-content> (P<\/jats:italic>\u00a0<\u00a00.0001). Receiver operating characteristic analysis showed that RV<\/jats:styled-content>\u2010SD<\/jats:styled-content>4 \u226524\u00a0ms was the cutoff value which predicts the adverse outcome following PBMV<\/jats:styled-content>. A considerable improvement of mean 6MWT<\/jats:styled-content> with significant reduction of BNP<\/jats:styled-content> levels after 12\u00a0months of follow\u2010up (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>0.001) in subjects with RV<\/jats:styled-content> dyssynchrony <24\u00a0ms.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Right ventricular dyssynchrony is a useful predictor of functional status, as assessed with 6MWTD<\/jats:styled-content> and BNP<\/jats:styled-content> level in patients with MS<\/jats:styled-content>. Furthermore, it might be considered as an independent predictor of adverse outcome following PMBV<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14227","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T07:43:36Z","timestamp":1545291816000},"page":"297-305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Right ventricular dyssynchrony and functional capacity before and after percutaneous balloon mitral valvuloplasty in patients with mitral stenosis: Determinants and clinical impact"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4052-6440","authenticated-orcid":false,"given":"Ragab A.","family":"Mahfouz","sequence":"first","affiliation":[{"name":"Cardiology Department Zagazig University Hospital Zagazig 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