Submitted: 13 Feb 2014
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J Cardiovasc Thorac Res. 2014;6(1): 9-14.
doi: 10.5681/jcvtr.2014.002
PMID: 24753825
PMCID: PMC3992741
  Abstract View: 1862
  PDF Download: 1964

Original Article

Electrocardiographic P-wave Indices as a Useful Tool to Predict Successful Percutaneous Balloon Mitral Valvotomy in Patients with Mitral Stenosis

Babak Kazemi, Ali Rostami, Naser Aslanabadi*, Samad Ghaffari

1 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran


Introduction: Patients with hemodynamically significant mitral stenosis (MS) have prolonged P-wave duration and increased P-wave dispersion (PWD) that decreases after successful percutaneous balloon mitral valvotomy (PBMV). The purpose of this study was to investigate if the changes in these indices may predict a successful procedure. Methods: Fifty two patients with MS in sinus rhythm underwent PBMV (90.4% female; mean age 38±10 years). Mitral valve area (MVA), valve score, mean diastolic mitral gradient (mMVG), mitral regurgitation severity, and systolic pulmonary artery pressure (sPAP) were evaluated by echocardiography before PBMV and repeated after one month. P-wave duration (Pmax / Pmin) and PWD were measured before and immediately after PBMV, at discharge, and at the end of the first month after discharge. Results:  Among all procedures 38 (73.1%) were defined as successful. Mean age, valve score, mMVG, and MVA before PBMV were similar for both groups. MVA was significantly greater in the successful PBMV group (1.65±0.27 vs. 1.41±0.22; p= 0.003). sPAP was reduced after PBMV in all patients and there were no significant differences in the mean sPAP before and after PBMV in both successful and unsuccessful groups. Pmax and PWD were significantly decreased immediately after the procedure (p= 0.035), the next day (p= 0.005) and at one month (p= 0.002) only in patients with successful PBMV. Pmin did not change significantly in either group. Conclusion: Only successful PBMV was associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV.
Keywords: Mitral Stenosis, P-wave Duration, P-wave Dispersion
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