الفهرس 
Detection of subtle myocardial dysfunction in symptomatic children with rheumatic heart disease using speckle tracking echocardiography
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Abstract
Background Acute rheumatic fever and rheumatic heart disease are major public health concerns in developing nations. More than 300,000 people die each year from cardiac-related complications. Early diagnosis and prophylactic treatment to prevent recurrences and subsequent valvular dysfunction is essential to reduce morbidity and mortality. Objectives: The aim of this study is to determine whether rheumatic heart diseasechildren with preserved systolic functions by conventional methods might have subtle changes that can be detected only by nonconventional methods. Methods: This is a case-control study which included 30children with rheumatic heart disease, compared to 23 healthy age-matched children. After history taking and cardiac examination, 2D Echocardiography, Tissue Doppler Imaging and Speckle Tracking Echocardiography were done to both groups. Results: The present study demonstrated that volume overload caused by valve regurgitation resulted in an obvious diastolic dysfunction. Patients with such diastolic dysfunction may show subtle regional myocardial dysfunction detected only by tissue Doppler imaging. Conclusion: Tissue Doppler Imaging, STE echocardiography are useful tools for the evaluation of RHD patients. They should be encouraged to be used in the evaluation of patients for their possible value in the early identification of subclinical LV myocardial dysfunction which may prove useful for the optimization of therapeutic strategies and the correct risk estimation