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HEMODYNAMIC FACTORS DETERMINING IMMEDIATE RESPONSE OF LEFT ATRIAL PRESSURE REDUCTION ATTRIBUTED TO BALLOON MITRAL VALVOTOMY | ||
| Journal of Al-Nahrain University - Science | ||
| Article 1, Volume 13, Issue 3, 2010, Pages 88-98 | ||
| Authors | ||
| Mawada Mousa Funjan; Kawthar H. Msayer; Zaid Mohammed Taha | ||
| Abstract | ||
| Rheumatic mitral stenosis is a chronic cardiac disease that results in considerable anatomical and functional alternations. Mitral stenosis (MS) is associated with elevated left atrial pressure (LAP). Balloon Mitral Valvuloplasty (BMV) is a proven modality in the treatment of mitral valve stenosis. The purpose of this study was to assess the success of balloon mitral Valvotomy via the measurements of LAP and PAP before and after procedures and to determine the hemodynamic factors that may influence reduction in mean LAP in patients with adequate relief of mitral valve obstruction after BMV. Twenty seven patients with moderate to severe mitral stenosis underwent cardiac catheterization. Hemodynamic measurements were recorded at pre-valvuloplasty and after balloon valvuloplasty. All patients were submitted to an echocardiography before BMV and the test was performed after the procedure to measure the mitral valve area. The results presented in this study were based on analysis of changes in mean left atrial pressure (LAP) attributed to BMV procedure quartiles in a sample of 27 patients with MS. The study subjects were categorized into ordered categories based on resulting quartiles of LAP change. The group with highest change included those in whom LAP was ( 18) mmHg after BMV, the second group with average response included those in whom LAP was (17) to (7) mmHg after BMV, and third group with lowest response included those in whom LAP was ( 6) mmHg after BMV. The changes in mean LAP attributed to procedure showed a statistically significant linear correlation with mean (LAP) before BMV (r 0.712, p<0.001), and mean pulmonary artery pressure (PAP) before BMV had a statistically significant linear correlation with changes in mean LAP attributed to procedure (r 0.68, p < 0.001). By using receiver operator characteristic curve (ROC) can distinguish the best homodynamic measurements before BMV that can be efficiently determine change in mean LAP attribute to BMV procedure. The (mean LAP and mean PAP) before the procedure (pretreatment) are an important contributing factors for determine the reduction in mean LAP attributed to BMV procedure. | ||
| Keywords | ||
| Mitral stenosis; Balloon mitral Valvotomy; Left atrial pressures | ||
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