Immediate and long-term effect of mitral balloon valvotomy on left ventricular volume and systolic function in severe mitral stenosis
Autor: | A. Khan, W.B. Choi, B. Khan, Vasudevan Sivanandam, A. Patel, Mohamed E. Fawzy, Layth Mimish, Jayaram Lingamanaicker |
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Rok vydání: | 1996 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Systole medicine.medical_treatment Mitral Balloon Valvotomy Ventricular Function Left Catheterization Internal medicine Mitral valve medicine Humans Mitral Valve Stenosis Term effect Child Cardiac catheterization Ejection fraction medicine.diagnostic_test business.industry Hemodynamics Middle Aged medicine.disease Myocardial Contraction Valvulotomy Stenosis Treatment Outcome medicine.anatomical_structure Angiography Cardiology Female Cardiology and Cardiovascular Medicine business |
Zdroj: | American Heart Journal. 132:356-360 |
ISSN: | 0002-8703 |
Popis: | To determine the immediate and long-term effect of mitral balloon valvotomy (MBV) on left ventricular (LV) volume and function, we studied 17 patients (mean age 27 +/- 9 years) with severe mitral stenosis undergoing MBV by cardiac catheterization and angiography before and immediately after MBV and at mean 12 months later. At baseline, LV end-diastolic volume index (EDVI) was reduced. Ten patients had EDVIor = 55 ml/m2, and four patients (23.5%) had LV ejection fraction50%. EDVI increased from 60 +/- 17 ml/m2 to 66 +/- 17 ml/m2 (p0.05) immediately after MBV and increased further to 72 +/- 16 ml/m2 (p0.05) later. Stroke volume index increased from 34 +/- 10 ml/m2 to 41 +/- 12 ml/m2 (p0.05) immediately after MBV and increased further to 50 +/- 11 ml/m2 (p0.001) later. LV end diastolic pressure increased from 12 +/- 5 mm HG to 16 +/- 4 mm HG (p0.05) immediately after MBV and fell to 13 +/- Hg at follow-up. LV ejection fraction increased from 57 +/- 7% to 62 +/- 6% (p0.05) immediately after MBV and 71 +/- 8% later (p0.001). Mean systolic ejection rate increased from 82 +/- 35 ml/sec to 101 +/- 48 ml/sec (p0.05) immediately after and 165 +/- 81 ml/sec later (p0.05). Systemic vascular resistance fell from 1887 +/- 525 dyne/sec/cm-5 to 1280 +/- 231 dyne/sec/cm-5 (p0.001) at follow-up. We conclude that the LV end-diastolic volume and systolic function are reduced in patients with mitral stenosis, and the LV end-diastolic volume is increased immediately after MBV and continues to increase at follow-up 12 months later; the LV ejection performance improves after successful MBV because of an increase in end-diastolic LV volume (preload) and reduction of SVR. |
Databáze: | OpenAIRE |
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