Conclusion
The aim of this study is to identify subtle ventricular dysfunction by speckle tracking echocardiography in children with active rheumatic heart disease, who are shown to have normal cardiac functions by conventional methods. In the literature, there are a very limited number of studies investigating myocardial strain. This is the first study assessing myocardial deformation during the acute phase of rheumatic heart disease. In this study, myocardial strain and strain rate values were lower in patients with acute RHD compared to healthy controls even in those with no valvular involvement. This data suggested that any patient with acute RHD can have some degree of myocardial involvement. This was thought to be due to myocardial dysfunction than valvular involvement. We need to perform more detailed studies to understand the reason behind myocardial dysfunction; however, based on available information this is more likely due to myocardial inflammation than myocardial necrosis. We need to identify the role of myocardial strain and strain rate on RHD pathophysiology, diagnosis and treatment with studies conducted on larger patient groups.