Left and right atrial function after percutaneous mitral valvuloplasty in mitral stenosis and sinus rhythm.
OBJECTIVE
Percutaneous mitral valvuloplasty (PMV) is an effective method for treating patients with severe mitral stenosis. The study aim was to compare left and right atrial appendage functions before and after PMV.


METHODS
Twenty-five patients (23 women, two men; mean age 38 +/- 9 years; range: 21-57 years) with severe mitral stenosis and sinus rhythm who underwent PMV were included in the study. Transesophageal echocardiography (TEE) was performed before and at six months after PMV, to evaluate the intensity of spontaneous echo contrast (SEC), left atrial appendage (LAA) dimensions and function, and right atrial appendage (RAA) function.


RESULTS
After PMV, the SEC (at TEE) was decreased in all patients, while increases were observed in the contraction and relaxation velocity flows of the LAA (pre-PMV 18 +/- 5 cm/s; post-PMV 24 +/- 9 cm/s; p < 0.001 and pre-PMV 25.5 +/- 10.2 cm/s; post-PMV 32.9 +/- 12.6 cm/s; p < 0.006, respectively). The tissue myocardial velocities were also increased in the LAA (pre-PMV 6.92 +/- 3.77 cm/s; post-PMV 11.16 +/- 6.61 cm/s; p < 0.002) and RAA (pre-PMV 16.2 +/- 3.7 cm/s; post-PMV 19.1 +/- 4.1 cm/s; p < 0.001).


CONCLUSIONS
In patients with mitral stenosis and sinus rhythm, improvements were noted in the left atrial, LAA and RAA systolic functions after PMV. This suggests that the relief of mitral stenosis may not only confer hemodynamic benefits to improve symptoms but also have a favorable influence on future thromboembolic complications. Thus, an early intervention might benefit patients with sinus rhythm by preventing the development of atrial fibrillation and systemic and pulmonary embolism.
Cianciulli
Tomás F
TF
Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires Dr. Cosme Argerich, Buenos Aires, Argentina. tcianciulli@fibertel.com.ar
Saccheri
María C
MC
Lax
Jorge A
JA
Sarmiento
Ricardo A
RA
Bermann
Alejandra M
AM
Gagliardi
Juan A
JA
Cirio
Juan J
JJ
Dorelle
Adriana N
AN
Prezioso
Horacio A
HA
Vidal
Luis A
LA
D000328:Adult; D016279:Atrial Function, Left / Q000502:physiology*; D016280:Atrial Function, Right / Q000502:physiology*; D002404:Catheterization; D018619:Echocardiography, Doppler, Pulsed; D017548:Echocardiography, Transesophageal; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D009200:Myocardial Contraction / Q000502:physiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D055815:Young Adult