Why the study?
Congenital pulmonary stenosis is a progressive disease treated primarily with balloon pulmonary valvuloplasty, but the relationship between biomarkers and echocardiographic markers and the impact of BPV on them required study.
Does balloon pulmonary valvuloplasty improve troponin levels and right ventricular function in patients with moderate and severe valvular pulmonary stenosis?
Does balloon pulmonary valvuloplasty improve troponin levels and right ventricular function in patients with moderate and severe valvular pulmonary stenosis?
Serum troponin I correlates with pulmonary stenosis severity and right ventricular dysfunction, and its re-elevation post-valvuloplasty may serve as a marker for restenosis.
Answers are grounded in this paper and cite their sources.
Troponin-echo correlations in PS may aid monitoring; leaves open BPV effects on biomarkers and RV function.
BACKGROUND: Congenital pulmonary stenosis (PS) is a progressive disease. Balloon pulmonary valvuloplasty (BPV) is the treatment of choice in valvular PS. AIM: We aim to study the relationship between biomarkers and echocardiographic markers in valvular PS and to assess the impact of BPV on these markers. PATIENTS AND METHODS: Patients with moderate and severe valvular PS amenable for BPV were recruited. Serum troponin I was measured. Echocardiographic assessment of PS and right ventricular (RV) function was done. All patients underwent BPV. Troponin level and echocardiographic data were re-assessed 2 weeks and 6 months after BPV. RESULTS: Fifty patients with valvular PS were recruited. There was significant correlation between peak SPG and troponin (P < .001). Troponin was significantly decreased 2 weeks after BPV. Similarly, there was an initial improvement in RV function. After 6 months of follow-up, we divided patients into two groups: Group A: 36 patients with no restenosis. Group B: 14 patients with restenosis. There were high significant differences between both groups regarding troponin level and RV functions with re-elevated troponin in Group B that correlated with peak PG (r = .9, P < .001). RV function parameters in Group B became significantly worse 6 months after BPV than those after the initial 2 weeks. CONCLUSION: Troponin correlates with the severity of PS and associates with RV dysfunction. Both troponin and RV functions improved with BPV. Recurrent elevation of troponin and impairment of RV function is associated with PV restenosis and could be set as an indication for repeated balloon dilatation of PV.
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Tahlawi et al. (2021) studied this question.
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