Key result
Balloon mitral valvotomy significantly improved global left atrial strain in patients with severe mitral stenosis at 24-48 hours post-procedure (13.4% to 17.37%, p < 0.001).
Why the study?
The effect of percutaneous balloon mitral valvotomy on global left atrial strain in patients with rheumatic severe mitral stenosis had not been well investigated.
Does percutaneous balloon mitral valvotomy improve global left atrial strain in patients with severe rheumatic mitral stenosis?
Case-Control (n=59)
Single-blind
No
Does percutaneous balloon mitral valvotomy improve global left atrial strain in patients with severe rheumatic mitral stenosis?
Absolute Event Rate: 17.37% vs 13.4%
p-value: p=<0.001
Successful percutaneous balloon mitral valvotomy significantly improves global left atrial strain within 24-48 hours in patients with severe rheumatic mitral stenosis.
Supports acute left atrial strain recovery after valvotomy; leaves open effects on clinical outcomes in prospective trials.
Background Global left atrial strain (LA) has been used as a novel assessment tool to evaluate left atrial function. However, not much has been investigated to study the effect of percutaneous balloon mitral valvotomy (BMV) in patients with rheumatic severe mitral stenosis on global LA strain. We studied the relationship between global left atrial (LA) strain and severe mitral stenosis and the effect of BMV on LA strain. Results A total of 29 patients satisfying the criteria for severe mitral stenosis underwent balloon mitral valvotomy (67% females; mean age, 39.53 ± 11.78 years). Global left atrial strain was assessed by speckle tracking echocardiography before and after valvuloplasty. Global LA strain was impaired in patients with severe mitral stenosis and improved 24–48 h following BMV (13.4 ± .75% vs 17.37 ± 6.95%, p < 0.001). There was a significant decrease in mitral mean gradient (MMG) (16.94 ± 6.62 mmHg vs 8.19 ± 4.01 mmHg, p < 0.001) and systolic pulmonary artery pressure (sPAP) (47.84 ± 9.07 mmHg vs 36.88 ± 7.69 mmHg, p < 0.001) after BMV. Mitral valve area (MVA) (1.045 ± 0.17 cm 2 vs 1.94 ± 0.22 cm 2 , p < 0.001) significantly increased after BMV. Results were compared with 30 age- and sex-matched healthy controls. Conclusion Global LA strain can be taken as an indicator of left atrial function, and its improvement following valvotomy may be taken as a good indicator of successful BMV.
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Reddy et al. (2019) conducted a case-control in Severe rheumatic mitral stenosis (n=59). Balloon mitral valvotomy vs. Pre-procedure baseline was evaluated on Global left atrial strain (p=<0.001). Balloon mitral valvotomy significantly improved global left atrial strain in patients with severe mitral stenosis at 24-48 hours post-procedure (13.4% to 17.37%, p < 0.001).
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