Correlation between mitral regurgitation grading and left ventricular systolic function in children with rheumatic fever

Background: Rheumatic fever (RF) and its valvular complications often occur in children 5-15 years old. Mitral regurgitation (MR) is a frequent valvular complication and can lead to decreased left ventricular (LV) systolic function. Objectives: To observe the correlation between MR grading and LV systolic function in children with RF. Method: A cross-sectional study was conducted by obtaining medical record data at Dr Soetomo General Academic Hospital from January 2015 to March 2019. Subjects were children aged 5 to 18 years with diagnosed RF. MR was found on echocardiography along with data regarding LV systolic function (ejection fraction, shortening fraction and LV end systolic diameter). Data were processed to derive frequency distribution then normality test with Shapiro Wilk and correlation with Spearman test; p <0.05 was considered significant. Results: A total of 40 children met the criteria, the percentage of males being more than females. Mean age was 11.32 years. Of the 40 children 37.5% had mild MR, 42.5% moderate MR, and 20% severe MR. The grading of MR had a significant positive correlation with LV end systolic diameter (r = 0.63; p = 0.001), and significant negative correlation with ejection fraction (r= -0.62; p = 0.001) and shortening fraction (r= -0.60; p = 0.001). Conclusions: In children with RF, grading of MR had a significant positive correlation with LV end systolic diameter and significant negative correlation with ejection fraction and shortening fraction.