title: Improvement of quality of life after percutaneous balloon mitral valvulotomy in patients with mitral stenosis: does rhythm matter?
abstract: OBJECTIVE
  Limited data are available on the effect of percutaneous balloon mitral valvulotomy (PBMV) on quality of life (QoL) in patients with mitral stenosis (MS), and whether the effect is similar between patients in sinus rhythm (SR) and with atrial fibrillation (AF). The study aim was to determine the effect of PBMV on the QoL of such patient groups.
  
  
  METHODS
  A total of 130 patients with symptomatic MS and scheduled for PBMV was studied. Patients with AF were predominantly male, and had more severe symptoms, a larger left atrial size and a lower left ventricular ejection fraction (LVEF). Baseline characteristics were collected together with PBMV outcomes. QoL was assessed using the SF-36 questionnaire at baseline, and at one and six months after PBMV. The QoL assessment included eight aspects: physical functioning; role physical; bodily pain; general health; vitality; social functioning; role emotional; and mental health. The raw scale was transformed into a transformed scale from 0 (worst) to 100 (best). Physical and mental subscales were calculated.
  
  
  RESULTS
  The cardiac rhythm was AF in 65 patients (50%). QoL on physical and mental scales was significantly improved after PBMV. There was no difference in the effect of PBMV on QoL improvement in patients with AF and SR. QoL improvement was demonstrated in all aspects, except for bodily pain. PBMV also improved NYHA functional class and mitral valve area, but decreased left atrial diameter and right ventricular systolic pressure in both groups. An increase in LVEF was observed in patients with AF CONCLUSION: PBMV was shown to improve QoL in patients with MS, irrespective of their baseline cardiac rhythm.
authors.affiliation: Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. sirkt@mahidol.ac.th
authors.forename: Rungroj
authors.initials: R
authors.lastname: Krittayaphong
authors.forename: Chunhakasem
authors.initials: C
authors.lastname: Chotinaiwatarakul
authors.forename: Charuwan
authors.initials: C
authors.lastname: Kangkagate
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications*; D002404:Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery*; D011788:Quality of Life