Key result
Severe mitral stenosis patients had significantly elevated afterload (Ea: 3.0 vs 1.5 mmHg ml-1; P<0.001) and LV contractility compared to controls, which tended to normalize following PTMC.
Why the study?
Does percutaneous transvenous mitral commisurotomy (PTMC) improve left ventricular performance and arterial load in patients with severe rheumatic mitral stenosis?
Population
106 subjects with severe rheumatic mitral stenosis, mean age 32 ± 8 years, 72% female, and 40 age-matched…
Comparison
Percutaneous transvenous mitral commisurotomy vs Age-matched healthy controls and pre-PTMC baseline
Design
Cohort
Follow-up
Immediately after PTMC
Authors
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PTMC may normalize afterload and contractility in severe mitral stenosis; hypothesis-generating and should not yet change practice.
Observational (n=146)
Does percutaneous transvenous mitral commisurotomy (PTMC) improve left ventricular performance and arterial load in patients with severe rheumatic mitral stenosis?
Absolute Event Rate: 3% vs 1.5%
p-value: p=<0.001
Severe mitral stenosis is associated with elevated LV contractility and arterial load that tend to normalize immediately after percutaneous transvenous mitral commisurotomy, though LV stiffness increases further.
Venkateshvaran et al. (2015) conducted an observational in severe rheumatic mitral stenosis (n=146). Percutaneous transvenous mitral commisurotomy (PTMC) vs. Age-matched controls was evaluated on Effective arterial elastance (Ea) (p=<0.001). Severe mitral stenosis patients had significantly elevated afterload (Ea: 3.0 vs 1.5 mmHg ml-1; P<0.001) and LV contractility compared to controls, which tended to normalize following PTMC.
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