Introduction: Pulmonary pulse transit time (pPTT) is a novel noninvasive echocardiographic measure to assess pulmonary arterial hemodynamics. It has been shown to be shorter in precapillary pulmonary hypertension (PHT). Mitral stenosis (MS) is one of the causes of postcapillary PHT. We aimed to investigate pPTT in patients with MS and its relationship with symptoms. Methods:We included 51 patients with MS (25 were asymptomatic, NYHA I, and 26 were symptomatic, NHYA II or III), and 50 controls, and evaluated their demographic characteristics and echocardiographic variables, including pPTT.Results: Baseline characteristics, including age, sex, body mass index, and cardiovascular risk factors, were similar between the MS and the control group. The pPTT was longer in the MS group than in the control group (0.21 ± 0.08 vs 0.15 ± 0.05, P < .001).Patients with symptomatic MS had longer pPTT than asymptomatic patients (P = .005).The pPTT was positively correlated with left atrial volume index and systolic pulmonary artery pressure, and negatively with tricuspid annular plane systolic excursion (r = .432; P < .001, r = .319; P = .001, r = −.293; and P = .003, respectively). Conclusion: The measurement of pPTT appears clinically relevant in patients withPHT. Further studies evaluating whether it is useful in distinguishing precapillary from postcapillary PHT are required. K E Y W O R D S arterial stiffness, echocardiography, mitral stenosis, pulmonary hypertension, pulmonary pulse transit time, pulmonary venous flow 1 | INTRODUCTION Although the incidence of rheumatic mitral stenosis (MS) has decreased considerably in industrialized countries, it remains a significant cause of morbidity in developing countries. 1 Valve area measured with planimetry constitutes the reference for grading severity, whereas mean transvalvular gradient and pulmonary artery pressure are rather indirect measures and have prognostic value. 2 In addition, the presence of high pulmonary arterial pressure is taken into account for deciding intervention in patients with clinically significant, albeit asymptomatic, mitral stenosis. 3 Left-sided heart disease is the most common cause of pulmonary hypertension (PHT), although severe PHT is relatively uncommon in this setting. Pulmonary hypertension can be diagnosed as either precapillary or postcapillary by using
Index of cardiac electrophysiological balance (iCEB), calculated as QT interval divided by QRS duration, has been described as a novel risk marker for predicting malignant ventricular arrhythmia. Increased levels of iCEB predict to torsades de pointes (TdP) and decreased levels of iCEB predict to non-torsades de pointes mediated ventricular tachycardia or ventricular fibrillation. The aim of this study is to evaluate arrhythmogenic risk by using iCEB in patients with coronary ectasia (CAE). Methods: Our study, designed as case-control, included 130 patients who were admitted to our outpatient clinic. 75 patients with isolated CAE (study group) and 55 healthy subjects (control group) were included in the study. Both groups underwent a standard 12-lead surface electrocardiogram and Tp-Te interval, QT interval, QRS interval, Tp-Te/QT ratio and QT/QRS ratio (iCEB) of patients were recorded and compared between groups. Results: Tp-e intervals and Tp-e/QT ratio is significantly higher in study group (p=0.001). And, iCEB was found as tend to be numerically higher in study group, but we could not match a statistically difference between groups (p=0.118). Tp-e and Tpe/QT ratio were higher in patients with two or three vessels CAE than one vessel (p value; for Tp-e p=0.024 and Tpe/QT ratio p=0.028). Although iCEB was found as higher with affected number of coronary artery, there was no statistically difference between groups. Conclusion: Our results demonstrate that CAE patients have significantly higher values of Tp-Te and Tp-Te/QT than controls. We need further studies to show increased arrhythmogenesis risk using iCEB for individuals with CAE.
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