Aslanabadi Naser, Jafaripour Iraj, Toufan Mehrnoush, Sohrabi Bahram, Separham Ahmad, Madadi Reza, Feazpour Hossein, Asgharzadeh Yosef, Ahmadi Mostafa, Safaiyan Abdolrasol, Ghafari Samad
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Biostatistics, Faculty Health, Tabriz University of Medical Science, Tabriz, Iran.
J Cardiovasc Thorac Res. 2015;7(1):32-7. doi: 10.15171/jcvtr.2014.07. Epub 2015 Mar 29.
Mitral stenosis (MS) causes structural and functional abnormalities of the left atrium (LA) and left atrial appendage (LAA), and studies show that LAA performance improves within a short time after percutaneous transvenous mitral commissurotomy (PTMC). This study aimed to investigate the effects of PTMC on left atrial function by transesophageal echocardiography (TEE).
We enrolled 56 patients with severe mitral stenosis (valve area less than 1.5 CM(2)). All participants underwent mitral valvuloplasty; they also underwent transesophageal echocardiography before and at least one month after PTMC.
Underlying heart rhythm was sinus rhythm (SR) in 28 patients and atrial fibrillation (AF) in remainder 28 cases. There was no significant change in the left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), or the left ventricular end systolic dimension (LVESD) before and after PTMC in both groups. However, both groups showed a significant decrease in the left atrial volume index (LAVI) following PTMC (P=0.032 in SR and P=0.015 in AF group). LAA ejection fraction (LAAEF) and the LAA emptying velocity (LAAEV) were improved significantly after PTMC in both groups with SR and AF (P<0.001 for both).
Percutaneous transvenous mitral commissurotomy improves left atrial appendage function in patients with mitral stenosis irrespective of the underlying heart rhythm.
二尖瓣狭窄（MS）会导致左心房（LA）和左心耳（LAA）出现结构和功能异常，研究表明经皮经静脉二尖瓣交界切开术（PTMC）后短时间内左心耳功能会有所改善。本研究旨在通过经食管超声心动图（TEE）研究PTMC对左心房功能的影响。
我们纳入了56例重度二尖瓣狭窄（瓣膜面积小于1.5平方厘米）患者。所有参与者均接受二尖瓣成形术；他们还在PTMC前及PTMC后至少1个月接受经食管超声心动图检查。
28例患者的基础心律为窦性心律（SR），其余28例为心房颤动（AF）。两组患者PTMC前后左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）或左心室收缩末期内径（LVESD）均无显著变化。然而，两组患者PTMC后左心房容积指数（LAVI）均显著降低（SR组P = 0.032，AF组P = 0.015）。SR组和AF组患者PTMC后左心耳射血分数（LAAEF）和左心耳排空速度（LAAEV）均显著改善（两组均P < 0.001）。
经皮经静脉二尖瓣交界切开术可改善二尖瓣狭窄患者的左心耳功能，无论其基础心律如何。
