title: Age, a predictive factor for the reduction in the mean transmitral pressure gradient after percutaneous balloon mitral valvotomy.
abstract: BACKGROUND
  The aim of this study was to evaluate the changes in mitral valve area and mean transmitral pressure gradient before and after percutaneous balloon mitral valvotomy and at 2 years of follow-up. We hypothesized that the patient's age would be an important determinant for the success of balloon valvotomy.
  
  
  METHODS
  We studied 24 patients with mitral stenosis (6 men and 18 women with an average age of 58 years, range 39 to 80 years), who underwent percutaneous balloon mitral valvotomy. Two-dimensional and Doppler echocardiographic examinations were taken before, immediately after and at a mean follow-up of 24 months (range 12 to 73 months). The correlation between the changes in the mitral valve area or mean transmitral pressure gradient and age was assessed with rank correlation and with stepwise multiple linear regression analysis correcting for sex, days of follow-up, heart rate score, pulmonary hypertension, mitral regurgitation and Wilkins score at follow-up.
  
  
  RESULTS
  Changes in the mitral valve area did not correlate with age. The reduction in mean transmitral pressure gradient at follow-up was associated with age with a 20.6% less reduction in mean transmitral pressure gradient (95% confidence interval 3.5-40.4%, p < 0.021) for every other year of the patients' age. When comparing changes in mean transmitral pressure gradient before and after percutaneous balloon mitral valvotomy, the strength and consistency of the association with age appeared similar (mean transmitral pressure gradient -0.9 +/- 3.0 vs -2.8 +/- 3.4 mmHg).
  
  
  CONCLUSIONS
  Age is a predictive factor for the reduction in mean transmitral pressure gradient after percutaneous balloon mitral valvotomy. This suggests that a better outcome is to be expected in younger patients, independently of the list of factors taken into consideration in our study.
authors.affiliation: Cardiology Department, Hammersmith Hospital, ICSM, London, UK. patriziavalentini@virgilio.it
authors.forename: Patrizia
authors.initials: P
authors.lastname: Valentini
authors.forename: Ferdinando Emanuele
authors.initials: FE
authors.lastname: Vegni
authors.forename: Petros
authors.initials: P
authors.lastname: Nihoyannopoulos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015999:Multivariate Analysis; D011312:Pressure; D012720:Severity of Illness Index