Introduction: The risk of left ventricular (LV) functional maladaptation and the right ventricular (RV) function reaction after surgery for isolated MR is poorly defined. We aimed to evaluate LV and RV contractile function using two-dimensional global speckle-tracking (2D GLS) analysis and the clinical status of patients with isolated mitral regurgitation (MR) after surgery.

 Methods: A cohort of 137 patients with significant MR undergoing mitral valve repair between July 2015 and May 2016 were prospectively enrolled. Serial echocardiographic studies were performed before surgery, 7 days after surgery and at least 3 months postoperatively. 

 Results: Mean age of patients was 65.8±12.7 years and 66 of them (48.2%) were male. Mean Euro Score I was 8.6 ± 8.5 %. Mean LV EF decreased from 57.4 ± 11.7% to 49.8 ± 11.2% (p<0.001), the LV GLS deteriorated from -19.2 ± 4.1 % to % -15.7 ± 3.8% (p<0.001) and the time dispersion increased from  88.3 ± 11.6 to 117.4 ± 115.2 msec (0.004). ). There was a significant reduction in TAPSE from 2.2 ± 0.55 mm to 1.8 ± 0.39 mm (p<0.001), as well as a reduction in the RV mean strain, from -16.91 ± 5.61% to -15.69 ± 4.12% (p=0.05). Tricuspid regurgitation showed a significant improvement after MR surgery (Figure 1). NYHA classification improved from 2.8 ± 0.6 to 1.9 ± 0.6 (p<0.001) and of 6-min walking test from 372.31 ± 31.6 m to 424.8 ± 117 m (p<0.001).

 Conclusion: After isolated mitral valve repair the increase of LV afterload leads to a deterioration of the LV contractile function and at the same time resulting in an more effective RV contractile function with reduction of the absolute values of TAPSE and RV mean strain, as well as an improvement in tricuspid regurgitation and improvement of the clinical status.