Subclinical left ventricular systolic function in rheumatic mitral stenosis: What is the role for clinical practice?

We have read the article by Gerede et al. (1) recently published in the Anatolian Journal of Cardiology 2016; 16: 772-7 entitled “Use of strain and strain rate echocardiographic imaging to predict the progression of mitral stenosis: a 5-year follow-up study” with a great interest. In this study, the authors evaluated the left ventricular global longitudinal strain (GLS) and strain rate (GLSR) in mitral valve stenosis (MS) and concluded that GLS and GLSR might be used as predictors of MS progression. There are some limitations of the present study. No detailed information was provided regarding the volume measurements of the cardiac chambers, presence of mitral regurgitation, assessment of the regional strain, and correlations of the deformation parameters with other comprehensive echocardiographic measures. There was no control group, which made it difficult to draw a conclusion. It would have been interesting to see the changes in the deformation measures over time if the investigators have measured GLS/GLSR at the end of the study