Key result
Percutaneous transvenous mitral commissurotomy significantly improved left atrial appendage ejection fraction and emptying velocity in patients with severe mitral stenosis in both sinus rhythm and atrial fibrillation.
Why the study?
Does percutaneous transvenous mitral commissurotomy improve left atrial appendage function in patients with severe mitral stenosis?
Observational (n=56)
No
Does percutaneous transvenous mitral commissurotomy improve left atrial appendage function in patients with severe mitral stenosis?
Absolute Event Rate: 56.11% vs 42.6%
p-value: p=<0.001
Percutaneous transvenous mitral commissurotomy significantly improves left atrial appendage function and reduces left atrial volume in patients with severe mitral stenosis, regardless of whether they are in sinus rhythm or atrial fibrillation.
PTMC was associated with improved LAA function in severe mitral stenosis; hypothesis-generating and should not yet change practice.
INTRODUCTION: Mitral stenosis (MS) causes structural and functional abnormalities of the left atrium (LA) and left atrial appendage (LAA), and studies show that LAA performance improves within a short time after percutaneous transvenous mitral commissurotomy (PTMC). This study aimed to investigate the effects of PTMC on left atrial function by transesophageal echocardiography (TEE). METHODS: We enrolled 56 patients with severe mitral stenosis (valve area less than 1.5 CM(2)). All participants underwent mitral valvuloplasty; they also underwent transesophageal echocardiography before and at least one month after PTMC. RESULTS: Underlying heart rhythm was sinus rhythm (SR) in 28 patients and atrial fibrillation (AF) in remainder 28 cases. There was no significant change in the left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), or the left ventricular end systolic dimension (LVESD) before and after PTMC in both groups. However, both groups showed a significant decrease in the left atrial volume index (LAVI) following PTMC (P=0.032 in SR and P=0.015 in AF group). LAA ejection fraction (LAAEF) and the LAA emptying velocity (LAAEV) were improved significantly after PTMC in both groups with SR and AF (P<0.001 for both). CONCLUSION: Percutaneous transvenous mitral commissurotomy improves left atrial appendage function in patients with mitral stenosis irrespective of the underlying heart rhythm.
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Aslanabadi et al. (2015) conducted an observational in Severe mitral stenosis (n=56). Percutaneous transvenous mitral commissurotomy (PTMC) vs. Baseline (Before PTMC) was evaluated on Left atrial appendage ejection fraction (LAAEF) in sinus rhythm patients (p=<0.001). Percutaneous transvenous mitral commissurotomy significantly improved left atrial appendage ejection fraction and emptying velocity in patients with severe mitral stenosis in both sinus rhythm and atrial fibrillation.
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