Clinical and echocardiographic differences in three different etiologies of severe mitral stenosis.
Background: In our institute, the causes of mitral stenosis (MS) are generally categorized into three main etiologies—rheumatic MS (RMS), degenerative MS with annular and leaflet calcification, and post‐clip MS as a consequence of transcatheter mitral valve repair with clips for treating mitral regu...
| Publicado en: | Echocardiography Vol. 39; no. 5; pp. 691 - 701 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156869294&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156869294 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: May2022 vid: 39 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 156869294 156066936 156869294 156869294 10.1111/echo.15348 156869294 ppf: 691 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Clinical and echocardiographic differences in three different etiologies of severe mitral stenosis. aug: au: Kagawa, Shunsuke Omori, Taku Uno, Goki Maeda, Mika Rader, Florian Siegel, Robert J. Shiota, Takahiro affil: Smidt Heart Institute, Cedars‐Sinai Medical Center, Los Angeles California, , USA sug: subj: Mitral Valve Stenosis Etiology Severity of Illness Echocardiography Mitral Valve Stenosis Diagnosis Mitral Valve Insufficiency Complications Mitral Valve Insufficiency Surgery Calcinosis Complications Human Retrospective Design Imaging, Three-Dimensional Echocardiography, Transesophageal Descriptive Statistics Dyspnea Risk Factors Ventricular Ejection Fraction Rheumatic Heart Disease Complications Heart Rate Physiology ab: Background: In our institute, the causes of mitral stenosis (MS) are generally categorized into three main etiologies—rheumatic MS (RMS), degenerative MS with annular and leaflet calcification, and post‐clip MS as a consequence of transcatheter mitral valve repair with clips for treating mitral regurgitation. However, clinical differences among the three etiologies are uncertain. Methods: We retrospectively assessed 293 consecutive patients (53 with RMS, 118 with degenerative MS, and 122 with post‐clip MS) who had a three‐dimensional (3D) transesophageal echocardiography (TEE) derived mitral valve orifice area (MVA) of ≤1.5 cm2, and a mean transmitral pressure gradient of ≥5 mmHg on transthoracic echocardiography. Results: Although there was no difference in 3D‐TEE‐derived MVA among the three groups, patients with post‐clip MS had a significantly lower mean transmitral pressure gradient compared to those with either of the other two types of MS (10.8 ([7.9–15.2] mmHg vs. 9.6 [7.3–12.5] mmHg vs. 6.9 [6.0–9.2] mmHg; p <.001). Patients with RMS had a higher prevalence of dyspnea. The independent determinants of dyspnea were pressure half time in RMS, 3D‐TEE‐derived MVA and estimated right atrial pressure in degenerative MS, and left ventricle ejection fraction in post‐clip MS. Conclusions: Patients with post‐clip MS had the lowest mean transmitral pressure gradient, and patients with RMS had the highest prevalence of dyspnea, despite having a similar 3D‐TEE‐derived MVA. The determinants of dyspnea were different among the three etiologies of MS. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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