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Hemodynamic and prognostic implications of net atrioventricular compliance in patients with mitral stenosis
DC Field | Value | Language |
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dc.contributor.author | Kim, Hyung-Kwan | - |
dc.contributor.author | Kim, Yong-Jin | - |
dc.contributor.author | Hwang, Seok-Jae | - |
dc.contributor.author | Park, Jin-Shik | - |
dc.contributor.author | Chang, Hyuk-Jae | - |
dc.contributor.author | Sohn, Dae-Won | - |
dc.contributor.author | Oh, Byung-Hee | - |
dc.contributor.author | Park, Young-Bae | - |
dc.date.accessioned | 2010-01-28T07:50:45Z | - |
dc.date.available | 2010-01-28T07:50:45Z | - |
dc.date.issued | 2007-10-12 | - |
dc.identifier.citation | J Am Soc Echocardiogr. 2008 May;21(5):482-6. Epub 2007 Oct 10. | en |
dc.identifier.issn | 1097-6795 (Electronic) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17928201 | - |
dc.identifier.uri | http://www.mdconsult.com/das/article/body/176309319-2/jorg=journal%26source=%26sp=20648195%26sid=0/N/642332/s0894731707005962.pdf?issn=08947317 | - |
dc.identifier.uri | https://hdl.handle.net/10371/46288 | - |
dc.description.abstract | BACKGROUND: On the basis of the close association of left atrial compliance with pulmonary hypertension in patients with mitral stenosis, we hypothesized that: (1) Doppler-derived net atrioventricular compliance (C(n)) can be used for predicting the occurrence of mitral valve (MV) replacement or percutaneous mitral commissurotomy (PMC); and (2) determinants of exercise capacity are variable depending on C(n). METHODS: We consecutively enrolled 26 patients (22 women; mean age, 47.0 +/- 6.1 years; range, 35-59 years) with pure moderate or severe mitral stenosis, in whom comprehensive echocardiography was performed at rest. C(n) was derived from the equation that has been previously validated (ie, C(n) = 1270 x [MV area by 2-dimensional planimetry/mitral E-wave downslope]. Measurements of stroke volume and systolic pulmonary artery pressure were repeated immediately after symptom-limited treadmill exercise test within 60 seconds. RESULTS: On the basis of earlier reports, C(n) less than 4 mL/mm Hg was selected to define abnormally small C(n). During a mean duration of 24-month follow-up, C(n) of less than 4 mL/mm Hg could reliably predict the occurrence of either MV replacement or PMC, which was confirmed by multivariate logistic regression analysis. In patients with C(n) less than 4 mL/mm Hg, exercise duration was found to be closely correlated primarily with resting systolic pulmonary artery pressure (r = -0.73, P = .03), whereas in patients with C(n) greater than or equal to 4 mL/mm Hg, postexercise stroke volume was the only determinant of exercise capacity (r = 0.49, P = .04). When combining C(n) less than 4 mL/mm Hg with MV area less than 1.0 cm(2) as a cut-off value for predicting MV replacement or PMC, the sensitivity improved from 63.6% to 81.8% (P = .05). CONCLUSIONS: Left atrial compliance estimated by C(n) with Doppler echocardiography allows us to effectively predict the future occurrence of MV replacement or PMC, with a special usefulness in patients with moderate mitral stenosis. In addition, determinants of exercise capacity were variable depending on the degree of C(n). | en |
dc.language.iso | en | en |
dc.publisher | Elsevier | en |
dc.subject | Adult | en |
dc.subject | Atrioventricular Node/*ultrasonography | en |
dc.subject | Echocardiography/*methods | en |
dc.subject | Exercise Test | en |
dc.subject | Female | en |
dc.subject | Humans | en |
dc.subject | Hypertension, Pulmonary/*complications/*ultrasonography | en |
dc.subject | Image Interpretation, Computer-Assisted/*methods | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Mitral Valve Stenosis/*complications/*ultrasonography | en |
dc.subject | Prognosis | en |
dc.subject | Reproducibility of Results | en |
dc.subject | Risk Assessment/*methods | en |
dc.subject | Risk Factors | en |
dc.subject | Sensitivity and Specificity | en |
dc.title | Hemodynamic and prognostic implications of net atrioventricular compliance in patients with mitral stenosis | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 김형관 | - |
dc.contributor.AlternativeAuthor | 김용진 | - |
dc.contributor.AlternativeAuthor | 황석재 | - |
dc.contributor.AlternativeAuthor | 박진식 | - |
dc.contributor.AlternativeAuthor | 장혁재 | - |
dc.contributor.AlternativeAuthor | 손대원 | - |
dc.contributor.AlternativeAuthor | 오병희 | - |
dc.contributor.AlternativeAuthor | 박영배 | - |
dc.identifier.doi | 10.1016/j.echo.2007.08.024 | - |
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