Background :
@EN Pulmonary venous flow(PVF) is closely related to left atrial pressure(LAP) and percutaneous mitral commissurotomy(PMC) reduces LAP rapidly. However, PVF pattern in mitral stenosis(MS) with sinus rhythm after PMC remains to be elucidated.
@ES Methods :
@EN Transesophageal echocardiographic pulsed Doppler examination was performed within 24 hours before and after PMC to evaluate PVF pattern in 10 patients of MS with sinus rhythm.
@ES Results :
@EN Before PMC, both peak velocity(PV) and velocity time integral(VTI) kduring systole had significant negative correlations with mean LAP(r=-0.70, r=-0.79, respectively). After PMC, both systolic PV and VTI increased significantly without
significant
changes in diastolic PV and VTI. However, there was no significant correlation between systolic PV and mean LAP, and between systolic VTI and mean LAP after PMC.
Mean LAP(mmHg) S-PV D-PV S-VTI D-VTI
Before PMc 27.2±7.1 0.36±0.05 0.34±0.09 0.05±0.01 0.07±0.03
After PMC 14.6±4.3* 0.57±0.14*^ 0.40±0.13*^ 0.11±0.04 0.07±0.03
S- ; systole, D- ; diastole, PV ; peak velocity(m/sec), VTI ; velocity time integral(m)
T- * ; p<0.01 vs. Before PMC, ^ ; p<0.01 vs. Diastole after PMC
@ES Conclusion :
@EN In mitral stenosis with sinus rhythm, these data suggest that systolic PVF decreases with increase of mean LAP and PMC could reverse this change without affecting diastolic PVF. However, acute emodynamic changes of left atrium induced by PMC
may
contribute to the absence of correlation between mean LAP and systolic PVF after PMC.
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