Abstract
Objective: To assess right ventricular function and right ventricular-pulmonary arterial (RV-PA) coupling by echocardiography in patients prior to mitral valve surgery. Methods: A cross-sectional descriptive study was conducted on 150 patients awaiting mitral valve replacement or repair at the Vietnam National Heart Institute, Bach Mai Hospital, from September 2025 to June 2026. Results: The mean age of the study population was 57.26 ± 8.5 years (males accounted for 60%). The prevalence of subclinical right ventricular dysfunction was notably high, among which right ventricular free wall strain (RVFWS) was the most sensitive parameter, detecting abnormalities in 70% of cases, outperforming S’ (58.7%), TAPSE (42.7%), and FAC (35.3%). The mean TAPSE/PASP ratio was 0.46 ± 0.18 mm/mmHg, demonstrating a strong negative correlation with PASP (r = -0.827; p < 0.001) and NT-proBNP levels (r = -0.246; p = 0.007), while positively correlating with FAC (r = +0.394; p < 0.001) and S’ (r = +0.269; p = 0.001). Severe pulmonary hypertension significantly increased the incidence of right ventricular impairment. Conclusion: Right ventricular dysfunction is highly prevalent in patients prior to mitral valve surgery. The combined assessment of RVFWS and the TAPSE/PASP ratio provides comprehensive hemodynamic information, significantly aiding in surgical prognostic stratification.
