Cardiovascular Magnetic Resonance in Predicting the Reduction in Pulmonary Artery Pressure in Patients With Mitral Stenosis After Surgical or Interventional Treatment
Abstract:
Background
Pulmonary hypertension (PH) is a common consequence of mitral stenosis (MS). After treatment, PH reverses depending on the chronicity and severity of MS. The characteristic changes in the pulmonary artery (PA) secondary to an elevated pulmonary artery pressure (PAP) can be evaluated via cardiovascular magnetic resonance imaging (CMR). In this study, we aimed to evaluate if there was any correlation between PAP and hemodynamic findings measured by CMR and whether these findings could be useful in predicting the PAP response after MS relief.
Methods
Thirty-three patients with a diagnosis of severe MS, who were candidated for percutaneously transvenous mitral commissurotomy (PTMC) or mitral valve replacement (MVR), were included. CMR was performed in all of them before the procedure and PA distensibility, PA peak velocity, PA forward volume, and PA forward flow were measured. Transthoracic echocardiography was performed at baseline, immediately after the procedure, and 3 months after MS relief for the assessment systolic PAP.
Results
Thirty-three patients with a diagnosis of MS PH (15 PTMC and 18 MVR) were enrolled in this study. The mean PAP at baseline catheterization ranged 25 to 70 mm Hg. There was a significant drop in systolic PAP immediately after the procedure and 3 months after MS relief. There was no relationship between the PA distensibility index and systolic PAP changes after MS relief. PA peak velocity was significantly higher in the patients with > 50% drops in their systolic PAP 3 months after the treatment. The multivariable analysis showed that none of the CMR findings was an independent predictor of a more systolic PAP decline.
Conclusions
Although we found no significant relationship between CMR findings and systolic PAP changes after MS treatment, the result of this study can be used for further investigations in this regard. (Iranian Heart Journal 2017; 18(1):30-36)
Language:
English
Published:
Iranian Heart Journal, Volume:18 Issue: 1, Spring 2017
Pages:
30 to 36
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