Key result
Advanced age in rheumatic mitral stenosis is linked to a ~68% severe valve calcification rate.
Why the study?
Do echocardiographic characteristics and mitral valve scores of rheumatic mitral stenosis differ between younger and elderly patients?
Observational (n=203)
No
Do echocardiographic characteristics and mitral valve scores of rheumatic mitral stenosis differ between younger and elderly patients?
Absolute Event Rate: 68% vs 3%
p-value: p=<0.001
Elderly patients with rheumatic mitral stenosis exhibit more severe degenerative changes in mitral valve structure compared to younger patients, often rendering them unsuitable for percutaneous commissurotomy.
May limit percutaneous commissurotomy eligibility in elderly patients; leaves open whether age-specific valve scores refine selection.
Background: Rheumatic heart disease (RHD) is common form of heart disease among population, especially in developing countries like India. Mitral stenosis (MS) is majorly caused by rheumatic heart disease with mitral commissural adhesion, fibrosis and calcification of the chordae tendineae. The aim of present study was clinical and echocardiographic evaluation for mitral stenosis in RHD patients with different age group. Methods: This was a retrospective, nonrandomized, and single-centre study in which 203 consecutive patients presented rheumatic mitral stenosis. All the patients were divided into different age group viz. 65 years. Cardiovascular examination and echocardiography were done in each patient. Mitral valve area (MVA), mitral valve gradient (MVG) and left atrial (LA) diameter were assessed by echocardiography. Mitral valve score was recorded to analyse the degenerative changes in mitral valve structure. Results: A total of 203 patients (133 females) were enrolled and divided into three age groups. Patients with age above 65 years were considered as elderly and those patients with age below 40 years were considered as younger. Echocardiographic assessment showed mean 4.7 and 4.9 cm LA diameter, 0.92 and 0.86 cm2 MVA and 11.2 and 9.7 mm Hg MVG in younger and elderly patients respectively. Total mitral valve score has shown significant (p 2 had shown significant difference (p < 0.001) between younger and elderly patients. Conclusion: Present study provides unique contemporary data on characteristics and management of patients with rheumatic mitral stenosis. Majority of elderly patients are unsuitable for percutaneous commissurotomy due to degenerative changes in mitral valve structure.
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Ramakrishna et al. (2017) conducted an observational in Rheumatic mitral stenosis (n=203). Older age (>65 years) vs. Younger age (<40 years) was evaluated on Calcification score > 2 (p=<0.001). Elderly patients (>65 years) with rheumatic mitral stenosis had significantly higher rates of severe valve calcification (68% vs 3%) and subvalvular thickening (61% vs 13%) compared to younger patients (<40 years).
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