Balloon mitral valvuloplasty: comparison of haemodynamic and echocardiographic assessment of mitral stenosis at different heart rates in the catheterisation laboratory.
OBJECTIVE
To compare echo-Doppler, Gorlin equation and haemodynamic methods of measuring mitral valve stenosis during right ventricular pacing-induced tachycardia before and after Inoue balloon mitral valvuloplasty to determine which method gave the most consistent results.


RESULTS
Measurements were made before and after valvuloplasty at: baseline heart rates, paced at 115 and then 145 beats/min. Mitral valve area by echo-Doppler was 1.1(+/-0.1) cm2 (mean +/- S.E.) before and 1.8(+/-0.2) cm2 after valvuloplasty; and by Gorlin equation: 0.9(+/-0.1) cm2 before and 1.5(+/-0.1) cm2 after. Echo-Doppler measurements were heart rate dependent but those by Gorlin measurements were not. At baseline, cardiac index was 2.08(+/-0.2) l min(-1), left atrial pressure 23.3(+/-7.9) mm Hg and mean mitral diastolic gradient 16.9(+/-9.9) mm Hg. After valvuloplasty, cardiac index was 2.31(+/-0.1) l min(-1), left atrial pressure fell to 19.2(+/-5.6) mm Hg and mean diastolic gradient was reduced to 8.5(+/-1.8) mm Hg.


CONCLUSIONS
The Gorlin mitral valve area appeared to be the most heart rate independent indicator of success following valvuloplasty.
Harcombe
A A
AA
Cardiac Unit, Papworth Hospital NHS Trust, Cambridge, UK. aah@papworth-tr.anglox.nhs.uk
Ludman
P F
PF
Wisbey
C
C
Crowley
J J
JJ
Sharples
L
L
Shapiro
L M
LM
D000368:Aged; D006328:Cardiac Catheterization; D002404:Catheterization; D004452:Echocardiography; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000503:physiopathology* / Q000628:therapy*