Document Detail

Assessing the severity of mitral stenosis: variability between noninvasive and invasive measurements in patients with symptomatic mitral valve stenosis.
MedLine Citation:
PMID:  10502227     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study evaluated the correlation and variability between noninvasive and invasive measures of mitral stenosis severity before and after balloon mitral commissurotomy (BMC) in a large group of patients with symptomatic mitral stenosis. Factors related to variability between measurements were determined. METHODS: The Doppler transmitral gradient, Doppler half-time valve area, and 2-dimensional echocardiographic (2D) mitral valve area (MVA) were measured immediately before and 1 day after BMC in 272 consecutive patients with mitral stenosis and compared with their respective measures during cardiac catheterization. RESULTS: The correlation coefficient for the comparison of noninvasive and invasive measurements of the transmitral gradient was 0.63 before BMC and 0.60 after the procedure; for 2D versus Gorlin-derived MVA, 0.39 and 0.57, respectively; and for Doppler half-time versus Gorlin-derived MVA, 0.31 and 0.18, respectively. A large degree of variability in the measurement of MVA was present among the 3 techniques before BMC and increased after BMC. Before BMC, for the comparison of 2D and Gorlin-derived MVA, variables predictive of the discrepancy were age, echocardiographic score, transmitral gradient during catheterization, and cardiac index. For the comparison of Doppler half-time versus Gorlin-derived MVA, age, heart rate during cardiac catheterization and echocardiography, cardiac output and left ventricular end-diastolic pressure predicted the difference between the 2 measures. CONCLUSIONS: In symptomatic patients with mitral stenosis, there is significant variability between noninvasive and invasive measures of mitral stenosis severity despite careful, reproducible measurements. The difference between noninvasive and invasive measures of MVA before BMC is strongly related to cardiac output.
A Wang; T Ryan; K B Kisslo; T M Bashore; J K Harrison
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  138     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  777-84     Citation Subset:  AIM; IM    
Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Balloon Dilatation
Cardiac Output
Echocardiography, Doppler
Heart Catheterization
Middle Aged
Mitral Valve Stenosis / diagnosis*,  therapy,  ultrasonography
Severity of Illness Index
Comment In:
Am Heart J. 2000 Oct;140(4):E21   [PMID:  11011318 ]

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