title: Improvement in exercise capacity and exercise hemodynamics 3 months after double-balloon, catheter balloon valvuloplasty treatment of patients with symptomatic mitral stenosis.
abstract: Clinical status, exercise treadmill performance, and hemodynamics were determined in 24 patients with symptomatic mitral stenosis before catheter balloon valvuloplasty (CBV) and at 3 months follow-up. Hemodynamic determinations at rest showed that mitral CBV performed by the double-balloon technique resulted in significant immediate decreases in mean pulmonary arterial wedge pressure (28 +/- 7 to 16 +/- 5 mm Hg, p less than .01), mean pulmonary arterial pressure (41 +/- 11 to 33 +/- 10 mm Hg, p less than .05), and mitral valve gradient (16 +/- 7 to 6 +/- 3 mm Hg, p less than .01), and significant increases in cardiac output (4.3 +/- 1.1 to 5.0 +/- 1.4 liters/min, p less than .01). Mitral valve area increased from 1.0 +/- 0.3 to 2.2 +/- 0.7 cm2 (p less than .01). The mitral valve area was unchanged (2.0 +/- 0.7 cm2, p = NS) at 3 months. The lower pulmonary arterial wedge pressure, pulmonary arterial pressure, and mitral valve gradient persisted at 3 month follow-up catheterization. Clinical examinations showed that before CBV, 21 of 24 patients were in New York Heart Association functional class III or IV; 3 months after CBV, 22 patients were in class I or II. Before CBV, the mean exercise treadmill time was 5.9 +/- 3.2 min and it had increased to 9.8 +/- 2.9 min (p less than .01) by the 3 month follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Department of Medicine, LAC-USC Medical Center 90033.
authors: C R
authors: CR
authors: McKay
authors: D T
authors: DT
authors: Kawanishi
authors: A
authors: A
authors: Kotlewski
authors: K
authors: K
authors: Parise
authors: T
authors: T
authors: Odom-Maryon
authors: A
authors: A
authors: Gonzalez
authors: C L
authors: CL
authors: Reid
authors: S H
authors: SH
authors: Rahimtoola
mesh_terms: D000328:Adult; D000368:Aged; D000790:Angiocardiography; D006328:Cardiac Catheterization; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D002933:Cineradiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000628:therapy; D008946:Mitral Valve Stenosis / Q000503:physiopathology* / Q000628:therapy; D005082:Physical Exertion