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经皮二尖瓣球囊成形术后狭窄的动脉僵硬改善。

Improved arterial stiffness in mitral stenosis after successful percutaneous balloon valvuloplasty.

机构信息

Department of Cardiology, Erciyes University Medical faculty, Kayseri, Turkey.

出版信息

Cardiol J. 2012;19(6):586-90. doi: 10.5603/cj.2012.0109.

Abstract

BACKGROUND

Rheumatic mitral stenosis (MS) is still a common disease in developing countries with high morbidity and mortality rates. The purpose of the study was to evaluate arterial stiffness in severe MS before and after percutaneous mitral balloon valvuloplasty (PMBV).

METHODS

Thirty patients with MS in sinus rhythm requiring PMBV and 20 age-gender matched healthy volunteers. The analyze of pulse wave velocities (PWV) were performed using of the carotid artery at the femoral by PWV technique on patients at baseline and a week after PMBV.

RESULTS

The values of PWV were significantly decreased after successful PMBW in MS patients. Mitral mean gradients and systolic pulmonary artery pressures (sPAP) both on echocardiography and catheterization also had a significant decrease after PMBW. The mitral valve areas were significantly increased after PMBW. There was a highly significant negative correlation between mitral valve areas and PWV values. A highly significant positive correlation was seen between mitral mean gradient on catheterization and PWV (r = 0.830, p 〈 0.001). There was also a significant correlation between sPAP on catheterization and PWV values (r = 0.639, p 〈 0.001). Echocardiographic mitral mean gradients and PWV were highly positive correlated with each other (r = 0.841, p 〈 0.001). The sPAP on echocardiography had also a highly positive correlation with PWV (r = 0.681, p 〈 0.001).

CONCLUSIONS

Mitral stenosis is a cause of impaired arterial stiffness and after the enlargened mitral valve area arterial stiffness improved in patients with MS.

摘要

背景

风湿性二尖瓣狭窄(MS)仍然是发展中国家的一种常见疾病,发病率和死亡率都很高。本研究的目的是评估经皮二尖瓣球囊成形术(PMBV)前后严重 MS 患者的动脉僵硬度。

方法

选择 30 例窦性心律需行 PMBV 的 MS 患者和 20 例年龄、性别匹配的健康志愿者。使用脉搏波速度(PWV)技术在基线时和 PMBV 后 1 周通过颈动脉-股动脉分析患者的 PWV。

结果

MS 患者成功 PMBW 后 PWV 值明显降低。经超声心动图和导管检查,二尖瓣平均梯度和收缩期肺动脉压(sPAP)在 PMBW 后也显著降低。PMBW 后二尖瓣瓣口面积明显增加。二尖瓣瓣口面积与 PWV 值呈高度负相关。导管检查的二尖瓣平均梯度与 PWV 呈高度正相关(r = 0.830,p 〈 0.001)。导管检查的 sPAP 与 PWV 值也有显著相关性(r = 0.639,p 〈 0.001)。超声心动图的二尖瓣平均梯度与 PWV 高度正相关(r = 0.841,p 〈 0.001)。超声心动图的 sPAP 也与 PWV 呈高度正相关(r = 0.681,p 〈 0.001)。

结论

二尖瓣狭窄是动脉僵硬度受损的原因,MS 患者扩大的二尖瓣瓣口面积后动脉僵硬度得到改善。

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