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Impact of cardiac rhythm on mitral valve area calculated by the pressure half time method in patients with moderate or severe mitral stenosis

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dc.contributor.authorKim, Hyung-Kwan-
dc.contributor.authorKim, Yong-Jin-
dc.contributor.authorChang, Sung-A-
dc.contributor.authorKim, Dae-Hee-
dc.contributor.authorSohn, Dae-Won-
dc.contributor.authorOh, Byung-Hee-
dc.contributor.authorPark, Young-Bae-
dc.date.accessioned2010-01-28T07:45:04Z-
dc.date.available2010-01-28T07:45:04Z-
dc.date.issued2009-01-10-
dc.identifier.citationJ Am Soc Echocardiogr. 2009 Jan;22(1):42-7.en
dc.identifier.issn1097-6795 (Electronic)-
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19131001-
dc.identifier.urihttp://www.mdconsult.com/das/article/body/176309319-2/jorg=journal%26source=%26sp=21586804%26sid=0/N/678183/s0894731708006652.pdf?issn=08947317-
dc.identifier.urihttp://hdl.handle.net/10371/46287-
dc.description.abstractBACKGROUND: The pressure half-time (PHT) method has been widely used to estimate mitral valve area (MVA) in patients with mitral stenosis (MS), in the belief that this simple method provides reliable information on true MVA. However, its limitation has been repeatedly recognized under different circumstances. The aim of this study was to evaluate the effect of cardiac rhythm on PHT-derived MVA calculation in relation to net atrioventricular compliance (C(n)). METHODS: Patients (n = 41) with rheumatic pure moderate or severe MS were consecutively recruited. Eighteen patients with sinus rhythm were allocated to group 1 and the remaining patients with chronic atrial fibrillation to group 2. MVA was obtained using the PHT method and by planimetry (considered the gold standard in this study). C(n) was calculated with a previously validated equation. RESULTS: There were no differences between the 2 groups in terms of age, gender, left ventricular dimensions or ejection fraction, or transmitral pressure gradient. Left atrial volume index (134.6 +/- 106.7 vs 79.2 +/- 16.8 mL; P = .003) and C(n) (6.6 +/- 1.5 vs 4.7 +/- 1.2 mL/mm Hg; P < .001) were higher in group 2 than in group 1. Disagreement of MVA estimation by PHT compared with that by 2-dimensional planimetry was 8.0 +/- 19.2% for group 1 and -24.9 +/- 13.9% for group 2 (P = .002). In addition, the extent of disagreement of PHT-derived MVA compared with that by 2-dimensional planimetry was significantly correlated with C(n) (r(2) = 0.71, P < .001). MVA by the PHT method was estimated to be substantially higher in patients with C(n) values < 4 mL/mm Hg, most of whom were in sinus rhythm. Multivariate analysis confirmed the independent association of cardiac rhythm with discrepancy of PHT-derived MVA compared with that by planimetry. CONCLUSION: Changes in cardiac rhythm with associated modifications of C(n) can alter the accuracy of the PHT method for estimating MVA. Given the limitation described here, 2-dimensional planimetry, not the PHT method, should be used as a primary echocardiographic tool for MVA calculation.en
dc.language.isoenen
dc.publisherElsevieren
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAlgorithmsen
dc.subjectAnatomy, Cross-Sectional/*methodsen
dc.subject*Blood Pressureen
dc.subjectComputer Simulationen
dc.subjectDiagnosis, Computer-Assisted/*methodsen
dc.subjectElectrocardiography/*methodsen
dc.subjectFemaleen
dc.subject*Heart Rateen
dc.subjectHumansen
dc.subjectImage Interpretation, Computer-Assisted/methodsen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMitral Valve Stenosis/*physiopathology/*ultrasonographyen
dc.subjectModels, Cardiovascularen
dc.subjectSeverity of Illness Indexen
dc.titleImpact of cardiac rhythm on mitral valve area calculated by the pressure half time method in patients with moderate or severe mitral stenosisen
dc.typeArticleen
dc.contributor.AlternativeAuthor김형관-
dc.contributor.AlternativeAuthor김용진-
dc.contributor.AlternativeAuthor장성아-
dc.contributor.AlternativeAuthor김대희-
dc.contributor.AlternativeAuthor손대원-
dc.contributor.AlternativeAuthor오병희-
dc.contributor.AlternativeAuthor박영배-
dc.identifier.doi10.1016/j.echo.2008.11.007-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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