Patients with low-gradient mitral stenosis demonstrated similar long-term outcomes and quality of life as those with high-gradient post successful balloon mitral valvuloplasty.
Does successful balloon mitral valvuloplasty result in similar long-term outcomes and quality of life in low-gradient compared to high-gradient very severe rheumatic mitral stenosis?
Patients with low-gradient very severe mitral stenosis achieve similar 5-year clinical outcomes and quality of life as those with high-gradient stenosis after successful balloon mitral valvuloplasty.
Absolute Event Rate: 0% vs 0%
Abstract Background Very severe mitral stenosis (VSMS) is defined as a mitral valve area (MVA) less than equal to 1 cm2, typically associated with a high trans-mitral gradient (more than equal to 10 mmHg) at a normal heart rate. However, low-gradient VSMS (less than 10 mmHg) is also frequently encountered in clinical practice. The long-term outcomes of successful Balloon Mitral Valvuloplasty (BMV) between high-gradient (HG) and low-gradient (LG) VSMS remain unclear. Purpose This study aims to evaluate and compare long-term clinical outcomes and quality of life (QoL) in patients with HG and LG VSMS following successful BMV. Methods We prospectively evaluated patients aged over 18 years who underwent successful BMV at our centre from March 2019 to March 2021. Five years after BMV, patients or their families (if deceased) were contacted by telephone to assess primary outcomes, including mortality, ischaemic stroke, heart failure rehospitalisation, and reintervention. Living patients were interviewed for QoL using the EQ-5D-5L questionnaire (The EuroQoL Group). Responses were categorised as 'no problems' or 'any problems' (ranging from slight to unable). Group comparisons were conducted using chi-square tests and Cox regression for survival analysis (SPSS v26.0, IBM, New York). A p-value less than 0.05 was considered statistically significant. Results Fifty-five patients were included in the study: 32 (58.2%) in the HG group and 23 (41.8%) in the LG group. The cohort was predominantly female. Forty-eight patients (87.3%) were successfully followed up after five years. No significant differences were observed in survival (LG vs. HG: 90% vs. 92%, p = 0.710), ischaemic stroke (0% vs. 3.5%, p = 1.00), rehospitalisation (10% vs. 10.7%, p = 1.00), or reintervention (0% vs. 7.1%, p = 0.50). The overall combined primary outcome was similar between groups (LG vs. HG: 20% vs. 28.6%, p = 0.735). In the QoL assessment, the proportion of patients reporting any problems in each domain showed no significant differences: mobility (LG vs. HG: 48% vs. 52%, p = 0.43), self-care (40% vs. 60%, p = 1.00), usual activities (47.1% vs. 52.6%, p = 0.73), pain/discomfort (47.4% vs. 52.6%, p = 0.65), and anxiety (53.3% vs. 46.7%, p = 0.37). EQ VAS scores, reflecting perceived health status, were also comparable between groups (80 50–98 vs. 80 40–100, p = 0.78). Conclusion Patients with low-gradient VSMS demonstrated similar long-term outcomes and quality of life compared to those with high-gradient VSMS following successful BMV.Baseline Characteristics Results
Vidianti et al. (Thu,) reported a other. Patients with low-gradient mitral stenosis demonstrated similar long-term outcomes and quality of life as those with high-gradient post successful balloon mitral valvuloplasty.