Cardiology Department, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
Scand J Clin Lab Invest. 2012 Oct;72(6):452-8. doi: 10.3109/00365513.2012.692485. Epub 2012 Jun 15.
Rheumatic mitral stenosis (RMS) is associated with increased thromboembolic event, especially in the presence of concomitant atrial fibrillation. In addition, increased platelet activity including elevated mean platelet volume (MPV) has been demonstrated in patients with RMS. It has also been reported that percutaneous mitral balloon valvuloplasty (PMBV) attenuates platelet activity. However, the impact of PMBV on MPV has never been studied. Accordingly, we aimed to investigate whether PMBV decreases MPV in patients with RMS.
In the present study, MPV was measured in 20 patients with RMS planned for PMBV just before and 1 month after the procedure. Twenty sex- and age- matched apparently healthy controls were used for comparison. Mitral valve area (MVA), transmitral gradient (TMG) and pulmonary artery pressure (PAP) were measured using transthoracic echocardiography.
As compared to apparently healthy controls, patients with RMS had higher MPV (9.05 ± 1.26 vs. 7.56 ± 0.74 fl, p < 0.001). All patients with RMS underwent successful PMBV. One month after the procedure, MVA, TMG and PAP were reduced significantly (p < 0.0001). As compared to values obtained before the procedure, white blood cell count, hemoglobin concentration and hematocrit remained unchanged. However, 1 month after the procedure platelet count had increased (p < 0.05) and MPV decreased significantly (to 7.78 ± 0.59, p < 0.0001). PMBV induced an absolute decrease in MPV more than 0.2 fl in 19 of 20 patients (95%).
As compared to apparently healthy controls, patients with RMS have higher MPV reflecting increased platelet activity, and PMBV is associated with a significant decrease in MPV 1 month after the procedure.
风湿性二尖瓣狭窄（RMS）与血栓栓塞事件的风险增加有关，尤其是在合并心房颤动的情况下。此外，已有研究表明 RMS 患者的血小板活性增加，包括平均血小板体积（MPV）升高。也有报道称经皮球囊二尖瓣成形术（PMBV）可降低血小板活性。然而，PMBV 对 MPV 的影响从未被研究过。因此，我们旨在研究 PMBV 是否会降低 RMS 患者的 MPV。
本研究纳入了 20 例计划行 PMBV 的 RMS 患者，在术前和术后 1 个月测量其 MPV。选择 20 名性别和年龄匹配的健康对照者进行比较。使用经胸超声心动图测量二尖瓣瓣口面积（MVA）、跨二尖瓣压差（TMG）和肺动脉压（PAP）。
与健康对照组相比，RMS 患者的 MPV 更高（9.05±1.26 比 7.56±0.74 fl，p<0.001）。所有 RMS 患者均成功接受了 PMBV。术后 1 个月，MVA、TMG 和 PAP 显著降低（p<0.0001）。与术前相比，白细胞计数、血红蛋白浓度和红细胞压积无变化。然而，术后 1 个月血小板计数增加（p<0.05），MPV 显著降低（至 7.78±0.59，p<0.0001）。20 例患者中有 19 例（95%）的 MPV 绝对下降超过 0.2 fl。
与健康对照组相比，RMS 患者的 MPV 更高，反映出血小板活性增加，PMBV 可导致术后 1 个月 MPV 显著降低。
