Key result
Percutaneous balloon mitral valvuloplasty improved left atrial appendage late emptying velocity (40.9 vs 23.0 cm/s; P<0.01), with Sa-wave ≤5.5 cm/s predicting an inactive appendage.
Why the study?
Does percutaneous balloon mitral valvuloplasty improve left atrial appendage function and reduce spontaneous echo contrast in patients with symptomatic mitral stenosis?
Observational (n=100)
Does percutaneous balloon mitral valvuloplasty improve left atrial appendage function and reduce spontaneous echo contrast in patients with symptomatic mitral stenosis?
Absolute Event Rate: 40.9% vs 23%
p-value: p=<.01
Percutaneous balloon mitral valvuloplasty significantly improves left atrial appendage function and reduces spontaneous echo contrast in patients with symptomatic mitral stenosis.
PBMV may improve LAA function and reduce SEC in mitral stenosis; leaves open effects on clinical events.
BACKGROUND: Thromboembolic events are the major cause of morbidity and mortality in patients with mitral stenosis (MS). This study aims to investigate left atrial spontaneous echo contrast (LA SEC), mitral annular systolic velocity (Sa-wave), left atrial appendage (LAA) late emptying velocity (LAAEV), LAA filling velocity (LAAFV) pre- and postpercutaneous balloon mitral valvuloplasty (PBMV) for MS. This also aims to study the association of LA SEC with inflammatory marker, high-sensitivity C-reactive protein (hs-CRP) in MS. METHODS: The study population consisted of 100 patients with symptomatic MS with sinus rhythm who underwent PBMV. Transthoracic echo (TTE), tissue Doppler imaging (TDI), and transesophageal echo (TEE) examinations were carried out before and 14 days following PBMV. High-sensitivity C-reactive protein (hs-CRP) was measured at the time of admission. RESULTS: The mean age was 33.2 ± 10.3 years with female preponderance (71%). There was a decrease in SEC grading, (pre-PBMV 2.8 ± 0.9 and post-PBMV 0.4 ± 0.1; P < .01), increase in LAAEV (pre-PBMV 23.0 ± 7.9 cm/s and post-PBMV 40.9 ± 8.4 cm/s; P < .01), and LAAFV (pre-PBMV 31.8 ± 9.3 cm/s and post-PBMV 51.2 ± 8.7 cm/s; P < .01).A significant positive correlation was present between LAAEV and Sa-wave (r = .52, P < .01). Correlation between hs-CRP and SEC was positive and significant (r = .33, P < .01). Optimal cutoff value of hs-CRP for prediction of moderate to dense SEC was >2.3 mg/dL, the cutoff value of Sa-wave was≤ 5.5 cm/s for prediction of the presence of inactive LAA (LAAEV < 25 cm/s). CONCLUSION: Mitral annular systolic velocity (Sa-wave) is an independent predictor of inactive LAA and a useful parameter in estimating inactive LAA in MS. Sa-wave and hs-CRP are independent predictors for SEC. PBMV improves LAA function in patients with MS.
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Arava et al. (2017) conducted an observational in Mitral stenosis (n=100). Percutaneous balloon mitral valvuloplasty (PBMV) vs. Pre-PBMV baseline was evaluated on Left atrial appendage late emptying velocity (LAAEV) (p=<.01). Percutaneous balloon mitral valvuloplasty improved left atrial appendage late emptying velocity (40.9 vs 23.0 cm/s; P<0.01), with Sa-wave ≤5.5 cm/s predicting an inactive appendage.
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