Babak Kazemi, Ali Rostami, Naser Aslanabadi
*, Samad Ghaffari
1 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
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.