Comparison of the usefulness of doppler pressure half-time in mitral stenosis in patients &lt;65 and ≥65 years of age

Abascal, Vivian M.; Moreno, Pedro R.; Rodriguez, L. Leonardo; Monterroso, Victor M.; Palacios, Igor F.; Weyman, Arthur E.; Davidoff, Ravin

doi:10.1016/s000-2914(99)x0064-4

Cited by 12 publications

(1 citation statement)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our relatively young patients, impaired ventricular myocardial relaxation is unlikely to have influenced on C n . 35 . In addition, particularly in MS, the LV fills on the flat low-volume portion at the left end of the pressure-volume curve.…”

Section: Discussionmentioning

confidence: 99%

Impact of Net Atrioventricular Compliance on Clinical Outcome in Mitral Stenosis

Nunes

Hung

Barbosa

et al. 2013

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

Background Net atrioventricular compliance (Cn) has been reported to be an important determinant of pulmonary hypertension in mitral stenosis (MS). We hypothesized that, as Cn reflects hemodynamic consequences of MS, it may be useful in assessing prognosis. To date, limited data with an assumed Cn cutoff have indicated the need for larger prospective studies. This prospective study was designed to determine the impact of Cn on clinical outcome and its contribution to pulmonary pressure in MS. In addition, we aimed to identify a cutoff value of Cn for outcome prediction in this setting. Methods and Results A total of 128 patients with rheumatic MS without other significant valve disease were prospectively enrolled. Comprehensive echocardiography was performed and Doppler-derived Cn estimated using a previously validated equation. The endpoint was either mitral valve intervention or death. Cn was an important predictor of pulmonary pressure, regardless of classic measures of MS severity. During a median follow-up of 22 months, the endpoint was reached in 45 patients (35%). Baseline Cn predicted outcome, adding prognostic information beyond that provided by mitral valve area and functional status. Cn ≤ 4 mL/mmHg best predicted unfavorable outcome in derivation and validation sets. A subgroup analysis including only initially asymptomatic patients with moderate to severe MS without initial indication for intervention (40.6 % of total) demonstrated that baseline Cn predicted subsequent adverse outcome even after adjusting for classic measures of hemodynamic MS severity (hazard ratio [HR] 0.33, 95% confidence interval [CI] 0.14–0.79, p = 0.013). Conclusions Cn contributes to pulmonary hypertension beyond of stenosis severity itself. In a wide spectrum of MS severity, Cn is a powerful predictor of adverse outcome, adding prognostic value to clinical data and mitral valve area. Importantly, baseline Cn predicts a progressive course with subsequent need for intervention in initially asymptomatic patients. Cn assessment therefore has potential value for clinical risk stratification and monitoring in MS patients.

show abstract

Section: Discussionmentioning

confidence: 99%