الفهرس 
ACKNOWLEDGEMENTOnly 14 pages are availabe for public view
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Abstract
Pulmonary hypertension is a common complication of LHDs (PH-LHD), frequently occurring as a symptom of the underlying condition and often related to disease severity. PH-LHD can complicate any left heart disorder, such as Mitral valve diseases. Global right ventricular function of the pressure-overloaded right ventricle in patients with mitral valve disease and pulmonary hypertension after successful Mitral Valve Replacement (MVR) has not been well-defined. The structure of the RV is complex, and needs to be described in segmental terms, similar to the left ventricle. Although in the past the right ventricle was described as the “forgotten chamber,” it is now a leading subject of investigation and technological innovation in the field of echocardiography and cardiovascular medicine. In this study we focused on right ventricular function and performance after performing Mitral valve replacement to the rheumatic heart disease patients associated with pulmonary hypertension, by conventional and tissue doppler echocardiography imaging methods. Obtained results showed: High significant differences among different variables in the form of increased TAPSE, RVFAC% and E peak. And decreased PAP, RA maximal volume, deceleration time, A peak and MPI. It is noted that PAP, TAPSE, RA maximum volume and MPI showed decrease in this significance at 6 months follow up. Meanwhile the significance of RVFAC%, A and E Peak velocities have been lost in the 6 months follow up. Moreover, on subgrouping analysis, it was found that the group of high pulmonary artery pressure mimics the overall group regarding initial improvement and subsequent decline in RV Function. However, the group of low pulmonary artery pressure showed initial improvement which sustained during the 6 months follows up evidenced by increased TAPSE, SV and EV. Decreased AV and MPI.