Utility of the Posterior to Anterior Mitral Valve Leaflets Length Ratio in Prediction of Outcome of Percutaneous Balloon Mitral Valvuloplasty

Background: Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). Objective: We propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length...

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Published inEchocardiography (Mount Kisco, N.Y.) Vol. 28; no. 10; pp. 1068 - 1073
Main Author Mahfouz, Ragab A.
Format Journal Article
LanguageEnglish
Published Malden, USA Blackwell Publishing Inc 01.11.2011
Subjects
Adolescent
Adult
Aged
balloon mitral valvuloplasty
Catheterization - statistics & numerical data
Echocardiography - methods
Echocardiography - statistics & numerical data
Egypt - epidemiology
Female
Humans
Male
Middle Aged
mitral leaflet length
Mitral Valve - diagnostic imaging
Mitral Valve Stenosis - epidemiology
Mitral Valve Stenosis - therapy
Organ Size
Prevalence
Prognosis
Reproducibility of Results
rheumatic heart disease
Risk Assessment - methods
Risk Factors
Sensitivity and Specificity
Treatment Outcome
Young Adult
Online AccessGet full text
ISSN0742-2822
1540-8175
1540-8175
DOI10.1111/j.1540-8175.2011.01527.x

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Abstract Background: Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). Objective: We propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length ratio (PMVL/AMVL length ratio). It could be a useful predictor to outcome of BMV. Subjects and methods: A total of 106 patients (mean age 29.1 ± 8.6 years) had MS with mitral valve score of eight or less. The length of anterior mitral valve leaflet and posterior mitral valve leaflet were measured. Patients were classified into group with ratio ≥1/2 and group of ratio <1/2. Eighty‐five healthy control subjects were studied. Results: Patients with PMVL/AMVL ratio ≥1/2 post‐BMV had lower transmitral gradients (4.5 ± 3.1 mmHg vs. 9.7 ± 2.1 mmHg, P < 0.002) and greater mitral valve area (MVA) (2.09 ± 0.3 cm2 vs. 1.5 ± 0.2 cm2, P < 0.001), lower pulmonary artery systolic pressure (PASP) (23.8 ± 14.3 mmHg vs. 34.2 ± 12.5 mmHg, P < 0.001), left atrial pressure (10.2 ± 6.7 mmHg vs. 18.9 ± 6.4 mmHg, P < 0.001), and lower incidence of de novo or worsening of mild mitral regurgitation (MR; 1.64% vs. 8.9%, 0% vs. 6.6%, P < 0.001). PMVL/AMVL length ratio was positively correlated with post‐BMV MVA (r = 0.69, P < 0.002), PASP (r = 0.592, P < 0.003), and negatively correlated with incidence of de novo or worsening of mild MR (r =–0.78, –0.93, P < 0.001). The regression analyses revealed that PMVL/AMVL ratio is the best and a reliable predictor of success and outcome of BMV, hazard ratio (95% confidence interval) 0.12 (0.05–52), P < 0.001. Conclusion: Length ratio of PMVL/AMVL assessment with echocardiography is an excellent simple predictor of post‐BMV mitral valve area and the cardiac events. (Echocardiography 2011;28:1068‐1073)
AbstractList Background: Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). Objective: We propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length ratio (PMVL/AMVL length ratio). It could be a useful predictor to outcome of BMV. Subjects and methods: A total of 106 patients (mean age 29.1 ± 8.6 years) had MS with mitral valve score of eight or less. The length of anterior mitral valve leaflet and posterior mitral valve leaflet were measured. Patients were classified into group with ratio ≥ 1/2 and group of ratio <1/2. Eighty‐five healthy control subjects were studied. Results: Patients with PMVL/AMVL ratio ≥ 1/2 post‐BMV had lower transmitral gradients (4.5 ± 3.1 mmHg vs. 9.7 ± 2.1 mmHg, P < 0.002) and greater mitral valve area (MVA) (2.09 ± 0.3 cm 2 vs. 1.5 ± 0.2 cm 2 , P < 0.001), lower pulmonary artery systolic pressure (PASP) (23.8 ± 14.3 mmHg vs. 34.2 ± 12.5 mmHg, P < 0.001), left atrial pressure (10.2 ± 6.7 mmHg vs. 18.9 ± 6.4 mmHg, P < 0.001), and lower incidence of de novo or worsening of mild mitral regurgitation (MR; 1.64% vs. 8.9%, 0% vs. 6.6%, P < 0.001). PMVL/AMVL length ratio was positively correlated with post‐BMV MVA (r = 0.69, P < 0.002), PASP (r = 0.592, P < 0.003), and negatively correlated with incidence of de novo or worsening of mild MR (r =–0.78, –0.93, P < 0.001). The regression analyses revealed that PMVL/AMVL ratio is the best and a reliable predictor of success and outcome of BMV, hazard ratio (95% confidence interval) 0.12 (0.05–52), P < 0.001. Conclusion: Length ratio of PMVL/AMVL assessment with echocardiography is an excellent simple predictor of post‐BMV mitral valve area and the cardiac events. (Echocardiography 2011;28:1068‐1073)
Background: Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). Objective: We propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length ratio (PMVL/AMVL length ratio). It could be a useful predictor to outcome of BMV. Subjects and methods: A total of 106 patients (mean age 29.1 ± 8.6 years) had MS with mitral valve score of eight or less. The length of anterior mitral valve leaflet and posterior mitral valve leaflet were measured. Patients were classified into group with ratio ≥1/2 and group of ratio <1/2. Eighty‐five healthy control subjects were studied. Results: Patients with PMVL/AMVL ratio ≥1/2 post‐BMV had lower transmitral gradients (4.5 ± 3.1 mmHg vs. 9.7 ± 2.1 mmHg, P < 0.002) and greater mitral valve area (MVA) (2.09 ± 0.3 cm2 vs. 1.5 ± 0.2 cm2, P < 0.001), lower pulmonary artery systolic pressure (PASP) (23.8 ± 14.3 mmHg vs. 34.2 ± 12.5 mmHg, P < 0.001), left atrial pressure (10.2 ± 6.7 mmHg vs. 18.9 ± 6.4 mmHg, P < 0.001), and lower incidence of de novo or worsening of mild mitral regurgitation (MR; 1.64% vs. 8.9%, 0% vs. 6.6%, P < 0.001). PMVL/AMVL length ratio was positively correlated with post‐BMV MVA (r = 0.69, P < 0.002), PASP (r = 0.592, P < 0.003), and negatively correlated with incidence of de novo or worsening of mild MR (r =–0.78, –0.93, P < 0.001). The regression analyses revealed that PMVL/AMVL ratio is the best and a reliable predictor of success and outcome of BMV, hazard ratio (95% confidence interval) 0.12 (0.05–52), P < 0.001. Conclusion: Length ratio of PMVL/AMVL assessment with echocardiography is an excellent simple predictor of post‐BMV mitral valve area and the cardiac events. (Echocardiography 2011;28:1068‐1073)
Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV).BACKGROUNDScoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV).We propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length ratio (PMVL/AMVL length ratio). It could be a useful predictor to outcome of BMV.OBJECTIVEWe propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length ratio (PMVL/AMVL length ratio). It could be a useful predictor to outcome of BMV.A total of 106 patients (mean age 29.1 ± 8.6 years) had MS with mitral valve score of eight or less. The length of anterior mitral valve leaflet and posterior mitral valve leaflet were measured. Patients were classified into group with ratio ≥1/2 and group of ratio <1/2. Eighty-five healthy control subjects were studied.SUBJECTS AND METHODSA total of 106 patients (mean age 29.1 ± 8.6 years) had MS with mitral valve score of eight or less. The length of anterior mitral valve leaflet and posterior mitral valve leaflet were measured. Patients were classified into group with ratio ≥1/2 and group of ratio <1/2. Eighty-five healthy control subjects were studied.Patients with PMVL/AMVL ratio ≥1/2 post-BMV had lower transmitral gradients (4.5 ± 3.1 mmHg vs. 9.7 ± 2.1 mmHg, P < 0.002) and greater mitral valve area (MVA) (2.09 ± 0.3 cm(2) vs. 1.5 ± 0.2 cm(2) , P < 0.001), lower pulmonary artery systolic pressure (PASP) (23.8 ± 14.3 mmHg vs. 34.2 ± 12.5 mmHg, P < 0.001), left atrial pressure (10.2 ± 6.7 mmHg vs. 18.9 ± 6.4 mmHg, P < 0.001), and lower incidence of de novo or worsening of mild mitral regurgitation (MR; 1.64% vs. 8.9%, 0% vs. 6.6%, P < 0.001). PMVL/AMVL length ratio was positively correlated with post-BMV MVA (r = 0.69, P < 0.002), PASP (r = 0.592, P < 0.003), and negatively correlated with incidence of de novo or worsening of mild MR (r =-0.78, -0.93, P < 0.001). The regression analyses revealed that PMVL/AMVL ratio is the best and a reliable predictor of success and outcome of BMV, hazard ratio (95% confidence interval) 0.12 (0.05-52), P < 0.001.RESULTSPatients with PMVL/AMVL ratio ≥1/2 post-BMV had lower transmitral gradients (4.5 ± 3.1 mmHg vs. 9.7 ± 2.1 mmHg, P < 0.002) and greater mitral valve area (MVA) (2.09 ± 0.3 cm(2) vs. 1.5 ± 0.2 cm(2) , P < 0.001), lower pulmonary artery systolic pressure (PASP) (23.8 ± 14.3 mmHg vs. 34.2 ± 12.5 mmHg, P < 0.001), left atrial pressure (10.2 ± 6.7 mmHg vs. 18.9 ± 6.4 mmHg, P < 0.001), and lower incidence of de novo or worsening of mild mitral regurgitation (MR; 1.64% vs. 8.9%, 0% vs. 6.6%, P < 0.001). PMVL/AMVL length ratio was positively correlated with post-BMV MVA (r = 0.69, P < 0.002), PASP (r = 0.592, P < 0.003), and negatively correlated with incidence of de novo or worsening of mild MR (r =-0.78, -0.93, P < 0.001). The regression analyses revealed that PMVL/AMVL ratio is the best and a reliable predictor of success and outcome of BMV, hazard ratio (95% confidence interval) 0.12 (0.05-52), P < 0.001.Length ratio of PMVL/AMVL assessment with echocardiography is an excellent simple predictor of post-BMV mitral valve area and the cardiac events.CONCLUSIONLength ratio of PMVL/AMVL assessment with echocardiography is an excellent simple predictor of post-BMV mitral valve area and the cardiac events.
Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). We propose a novel yet simple, independent parameter of MS severity based on the posterior mitral valve leaflet to anterior mitral valve leaflet length ratio (PMVL/AMVL length ratio). It could be a useful predictor to outcome of BMV. A total of 106 patients (mean age 29.1 ± 8.6 years) had MS with mitral valve score of eight or less. The length of anterior mitral valve leaflet and posterior mitral valve leaflet were measured. Patients were classified into group with ratio ≥1/2 and group of ratio <1/2. Eighty-five healthy control subjects were studied. Patients with PMVL/AMVL ratio ≥1/2 post-BMV had lower transmitral gradients (4.5 ± 3.1 mmHg vs. 9.7 ± 2.1 mmHg, P < 0.002) and greater mitral valve area (MVA) (2.09 ± 0.3 cm(2) vs. 1.5 ± 0.2 cm(2) , P < 0.001), lower pulmonary artery systolic pressure (PASP) (23.8 ± 14.3 mmHg vs. 34.2 ± 12.5 mmHg, P < 0.001), left atrial pressure (10.2 ± 6.7 mmHg vs. 18.9 ± 6.4 mmHg, P < 0.001), and lower incidence of de novo or worsening of mild mitral regurgitation (MR; 1.64% vs. 8.9%, 0% vs. 6.6%, P < 0.001). PMVL/AMVL length ratio was positively correlated with post-BMV MVA (r = 0.69, P < 0.002), PASP (r = 0.592, P < 0.003), and negatively correlated with incidence of de novo or worsening of mild MR (r =-0.78, -0.93, P < 0.001). The regression analyses revealed that PMVL/AMVL ratio is the best and a reliable predictor of success and outcome of BMV, hazard ratio (95% confidence interval) 0.12 (0.05-52), P < 0.001. Length ratio of PMVL/AMVL assessment with echocardiography is an excellent simple predictor of post-BMV mitral valve area and the cardiac events.
Author Mahfouz, Ragab A.
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/21966895$$D View this record in MEDLINE/PubMed
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Snippet Background: Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). Objective: We propose...
Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV). We propose a novel yet simple,...
Scoring of mitral stenosis (MS) severity is very important for selection of patients for balloon mitral valvuloplasty (BMV).BACKGROUNDScoring of mitral...
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StartPage 1068
SubjectTerms Adolescent
Adult
Aged
balloon mitral valvuloplasty
Catheterization - statistics & numerical data
Echocardiography - methods
Echocardiography - statistics & numerical data
Egypt - epidemiology
Female
Humans
Male
Middle Aged
mitral leaflet length
Mitral Valve - diagnostic imaging
Mitral Valve Stenosis - epidemiology
Mitral Valve Stenosis - therapy
Organ Size
Prevalence
Prognosis
Reproducibility of Results
rheumatic heart disease
Risk Assessment - methods
Risk Factors
Sensitivity and Specificity
Treatment Outcome
Young Adult
Title Utility of the Posterior to Anterior Mitral Valve Leaflets Length Ratio in Prediction of Outcome of Percutaneous Balloon Mitral Valvuloplasty
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https://www.ncbi.nlm.nih.gov/pubmed/21966895
https://www.proquest.com/docview/904009363
Volume 28
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