Vieira Marcelo L Campos, Silva Murilo C, Wagner Camila R, Dallan Luis A, Kajita Luis J, Oliveira Wercules A, Samesina Nelson, Hotta Viviane T, Mathias Wilson, Spina Guilherme, Cardoso Luis, Pastore Carlos A, Tarasoutchi Flávio, Grinberg Max
InCor, São Paulo University Medical School, Brasil.
Rev Esp Cardiol (Engl Ed). 2013 Jan;66(1):17-23. doi: 10.1016/j.recesp.2012.05.007. Epub 2012 Aug 9.
The left atrium is clinically relevant in patients with mitral valve stenosis. The objective of this study was to analyze the effects of percutaneous balloon valvuloplasty on left atrium volumes and the left atrium emptying fraction in symptomatic mitral valve stenosis patients using 2-dimensional and real-time 3 -dimensional transthoracic echocardiography.
We carried out a prospective study of 28 consecutive symptomatic mitral valve stenosis patients, aged 22-72 (39 [11.5]) years, 24/28 (85.6%) women, who underwent to percutaneous balloon valvuloplasty between March 2009 and May 2011. Patients underwent 2- and 3-dimensional transthoracic and transesophageal echocardiography (atrial fibrillation) and invasive mitral valve area measurement. Echocardiographic analysis was performed before, 72 h after and 12 months after percutaneous balloon valvuloplasty. The following parameters were analyzed: a) mitral valve area (2-dimensional planimetry, pressure half-time, 3-dimensional echocardiography, invasive hemodynamic measurement); b) indexed left atrium maximum and indexed minimum volumes, and c) left atrium emptying fraction.
The 3-dimensional parameters of the mitral valve stenosis patients before and 72 h and 12 months after percutaneous balloon valvuloplasty were as follows: a) mitral valve area: 0.9 (0.1) cm(2); 1.8 (0.2) cm(2) (P<.001); 1.7 (0.2) cm(2) (P<.001); b) left atrium maximum volumes: 49.9 (12) mL/m(2); 42 (11.4) mL/m(2) (P<.001); 40.3 (10.2) mL/m(2) (P<.001), and c) left atrium emptying fraction: 30.1 (9.4%); 40.6 (7.4%) (P<.001); 44.1 (8%) (P<.001), respectively.
In symptomatic mitral valve stenosis patients who underwent percutaneous balloon valvuloplasty analysis by 2- and 3-dimensional echocardiography, improvements in left atrium reverse remodeling and left atrium emptying fraction were observed 72 h and 12 months after the procedure.
左心房在二尖瓣狭窄患者中具有临床相关性。本研究的目的是使用二维和实时三维经胸超声心动图分析经皮球囊瓣膜成形术对有症状二尖瓣狭窄患者左心房容积和左心房排空分数的影响。
我们对2009年3月至2011年5月期间连续28例有症状二尖瓣狭窄患者进行了一项前瞻性研究，患者年龄22 - 72（39 [11.5]）岁，24/28（85.6%）为女性，均接受了经皮球囊瓣膜成形术。患者接受了二维和三维经胸及经食管超声心动图检查（房颤患者）以及二尖瓣口面积的有创测量。在经皮球囊瓣膜成形术前、术后72小时和术后12个月进行超声心动图分析。分析了以下参数：a）二尖瓣口面积（二维平面测量法、压力减半时间、三维超声心动图、有创血流动力学测量）；b）左心房最大和最小容积指数，以及c）左心房排空分数。
二尖瓣狭窄患者经皮球囊瓣膜成形术前、术后72小时和术后12个月的三维参数如下：a）二尖瓣口面积：0.9（0.1）cm²；1.8（0.2）cm²（P <.001）；1.7（0.2）cm²（P <.001）；b）左心房最大容积：49.9（12）mL/m²；42（11.4）mL/m²（P <.001）；40.3（10.2）mL/m²（P <.001），以及c）左心房排空分数：分别为30.1（9.4%）；40.6（7.4%）（P <.001）；44.1（8%）（P <.001）。
在接受经皮球囊瓣膜成形术的有症状二尖瓣狭窄患者中，通过二维和三维超声心动图分析发现，术后72小时和12个月时左心房逆向重构和左心房排空分数均有改善。
