Document Detail

Mitral valve reserve in double-orifice technique: an exercise echocardiographic study.
MedLine Citation:
PMID:  12358399     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM OF THE STUDY: The edge-to-edge technique is used to restore valvular competence in mitral insufficiency. The efficacy of the method is under debate due to the potential for creating functional mitral stenosis. An exercise echocardiographic study was carried out to investigate valve function and hemodynamics in patients who had undergone double-orifice mitral valve repair. METHODS: Thirty patients (mean age 49.1 +/- 12.7 years) with previous double-orifice mitral valve repair underwent exercise echocardiography (10 W/min). An annular prosthesis was present in 28 patients (93%). The mean and maximum mitral valve gradient, planimetric valve area, stroke volume, systolic pulmonary artery pressure, heart rate and systolic blood pressure were measured at baseline and at peak stress. RESULTS: At peak stress, heart rate (77.7 +/- 12.2 versus 118.6 +/- 26.0 beats/min, p < 0.00001), systolic blood pressure (124.1 +/- 10.9 versus 146.6 +/- 22.8 mmHg, p < 0.00001) and stroke volume (78.0 +/- 10.2 versus 97.0 +/- 15.1 ml, p < 0.00001) were significantly increased, showing a physiological behavior of the mitral valve. The mean mitral valve gradient (2.8 +/- 1.3 versus 4.6 +/- 1.9 mmHg, p < 0.00001), maximum mitral valve gradient (6.4 +/- 2.8 versus 10.5 +/- 4.6 mmHg, p < 0.00002) and systolic pulmonary artery pressure (22.8 +/- 6.1 versus 28.2 +/- 9.9 mmHg, p < 0.001) were increased, but not to pathologic levels. Planimetric valve area increased significantly (3.2 +/- 0.6 versus 4.3 +/- 0.7 cm2, p < 0.00001). A significant negative linear correlation was found between the relative change in mitral valve area and planimetric valve area at rest (r = -0.51, p < 0.05). CONCLUSION: The double-orifice repair, even with concomitant ring annuloplasty, does not cause mitral valve obstruction, either at baseline or during physical exercise, and does not affect valve hemodynamic and valve reserve.
Eustachio Agricola; Francesco Maisano; Michele Oppizzi; Michele De Bonis; Lucia Torracca; Giovanni La Canna; Ottavio Alfieri
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  11     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-10-02     Completed Date:  2003-01-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  637-43     Citation Subset:  IM    
Division of Non-Invasive Cardiology, San Raffaele Hospital, IRCCS, Milan, Italy.
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MeSH Terms
Cardiac Volume / physiology
Echocardiography, Stress*
Exercise Test*
Follow-Up Studies
Heart Valve Prosthesis Implantation / adverse effects*
Hemodynamics / physiology
Middle Aged
Mitral Valve / physiopathology*,  surgery*,  ultrasonography
Mitral Valve Insufficiency / physiopathology*,  surgery*,  ultrasonography
Mitral Valve Stenosis / etiology*,  physiopathology*,  ultrasonography
Outcome Assessment (Health Care)

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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