Accuracy of Mitral Valve Leaflets Tips Separation Assessed by 3D Transthoracic Echocardiography in Predicting Rheumatic Mitral Valve Stenosis Severity

Background: A significant cause of cardiovascular load in developing nations is mitral stenosis (MS), which is primarily due to rheumatic fever. Aim and objectives: To assess the accuracy of mitral valve leaflets tips separation by 3DTTE in predicting the severity of rheumatic mitral valve stenosis and comparing MLS index by 3DTTE and MLS index by 2DTTE using planimetered MVA by 3DTEE as a reference method. Patients and methods: This analytic cross-sectional study was conducted at the Cardiology Department of Al-Azhar University (Bab El-Sheriya University Hospital) from September 2022 to October 2023. It included sixty consecutive patients candidates for TEE evaluation; thirty did not have rheumatic mitral valve stenosis, and thirty others had significant rheumatic mitral valve stenosis (mitral valve area ≤ 1.5 cm2 by 2D TTE). Results: According to our research, MLSI2D and MLSI3D have excellent predictive power for MS severity. Our findings also demonstrate that MLSI3D is an accurate, user-friendly, and readily accessible index that can be used as an alternative to other techniques for assessing the severity of MS, particularly by general cardiologists. This would lead to even more precise decision-making. Conclusion: Mitral leaflet separation assessed by 3D TTE has a reliable and unremarkable ability to predict the severity of rheumatic mitral stenosis. MLS assessed by 3D TTE is more accurate than MLS by 2D TTE in the prediction of the severity of mitral stenosis