Proposed pathophysiology of left ventricular (LV) dysfunction in mitral stenosis include4 Chronic inflammation leading to myocardial fibrosis Scarring of the sub valvular apparatus leading to wall motion abnormality Reduced LV compliance Increased afterload leading to LV remodelling Abnormal right-left septal interaction due to significant pulmonary hypertension Concomitant disease such as hypertension and coronary artery disease Reduced filling of LV