Introduction: Current echocardiographic parameters have a limitation in assessing mitral valve(MV)apparatus in rheumatic mitral stenosis (MS)patient. In the current study, we use 2 dimensional(2D)longitudinal strain (S) and strain rate (Sr) imaging in evaluating the papillary muscle longitudinal strain (LS) as an objective and quantitative echocardiographic parameter with high reproducibility in the assessment of MV apparatus in patients with mild to moderate rheumatic MS with preserved ejection fraction(EF%).？Patients and Method: The study included 40 patients with established diagnosis of MS subdivided in to 31 patients with moderate MS(mean age:32 ± 5) and 9 patients with mild MS(mean age:31 ± 6). 20 healthy individuals(mean age 31 ±6) as a control for
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