Pulmonary arterial pressure detects functional mitral stenosis after annuloplasty for primary mitral regurgitation: An exercise stress echocardiographic study

Samiei, N. and Tajmirriahi, M. and Rafati, A. and Pasebani, Y. and Rezaei, Y. and Hosseini, S. (2018) Pulmonary arterial pressure detects functional mitral stenosis after annuloplasty for primary mitral regurgitation: An exercise stress echocardiographic study. Echocardiography, 35 (2). pp. 211-217.

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Abstract

Introduction: The restrictive mitral valve annuloplasty (RMA) is the treatment of choice for degenerative mitral regurgitation (MR), but postoperative functional mitral stenosis remains a matter of debate. In this study, we sought to determine the impact of mitral stenosis on the functional capacity of patients. Methods: In a cross-sectional study, 32 patients with degenerative MR who underwent RMA using a complete ring were evaluated. All participants performed treadmill exercise test and underwent echocardiographic examinations before and after exercise. Results: The patients� mean age was 50.1 ± 12.5 years. After a mean follow-up of 14.1 ± 5.9 months (6�32 months), the number of patients with a mitral valve peak gradient >7.5 mm Hg, a mitral valve mean gradient >3 mm Hg, and a pulmonary arterial pressure (PAP) �25 mm Hg at rest were 50, 40.6, and 62.5, respectively. 13 patients (40.6) had incomplete treadmill exercise test. All hemodynamic parameters were higher at peak exercise compared with at rest levels (all P <.05). The PAP at rest and at peak exercise as well as peak transmitral gradient at peak exercise were higher in patients with incomplete exercise compared with complete exercise test (all P <.05). The PAP at rest (a sensitivity and a specificity of 84.6 and 52.6, respectively; area under the curve AUC =.755) and at peak exercise (a sensitivity and a specificity of 100% and 47.4%, respectively; AUC =.755) discriminated incomplete exercise test. Conclusion: The RMA for degenerative MR was associated with a functional stenosis and the PAP at rest and at peak exercise discriminated low exercise capacity. © 2017, Wiley Periodicals, Inc.

Item Type: Article
Additional Information: cited By 0
Depositing User: eprints admin
Date Deposited: 05 Aug 2018 04:06
Last Modified: 05 Aug 2018 04:06
URI: http://eprints.iums.ac.ir/id/eprint/685

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