Respiratory muscle strength in rheumatic mitral stenosis improves after balloon valvotomy.
BACKGROUND
Dyspnea is a common symptom in a patient with valvular heart disease. The mechanism underlying this disease is still uncertain. Respiratory muscle weakness has been proposed to be one of the mechanisms underlying dyspnea in heart failure, but this has not been adequately studied in valvular heart disease.


METHODS
We prospectively studied 20 patients with rheumatic mitral valve stenosis who were candidates for percutaneous balloon mitral valvotomy. Respiratory muscle strength assessment by maximal static inspiratory mouth pressure and maximal static expiratory mouth pressure was done on all patients at baseline and at 1 week after the procedure. The severity of dyspnea in study participants was also studied by the 6-min walk test and visual analog scale.


RESULTS
Balloon valvotomy was followed by a significant improvement in the 6-min walking distance (from 219 +/- 30.15 to 237.55 +/- 32.25 m, P < 0.001), visual analog scale as a measure of dyspnea (from 60.95 +/- 12.16 to 44.4 +/- 13.71 mm, P < 0.001), inspiratory muscle strength (from 51.9 +/- 10.28 to 56.55 +/- 11.87 cmH2O, P < 0.001) and expiratory muscle strength (from 62.15 +/- 19.68 to 67.20 +/- 21.91 cmH2O, P < 0.001).


CONCLUSIONS
Improvement in dyspnea in mitral stenosis after balloon valvotomy is associated with significant improvement in respiratory muscle strength.
Palaniswamy
Chandrasekar
C
Department of Medicine, New York Medical College, Valhalla, New York, USA. drpchandrasekar@gmail.com <drpchandrasekar@gmail.com>
Selvaraj
Dhana R
DR
Guleria
Randeep
R
Mohan
Anant
A
Sugunaraj
Jaya Prakash
JP
Ramamurthy
Shankar
S
Narang
Rajiv
R
D000328:Adult; D002404:Catheterization; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D053580:Muscle Strength; D011446:Prospective Studies; D012132:Respiratory Muscles / Q000503:physiopathology*; D012214:Rheumatic Heart Disease / Q000150:complications / Q000628:therapy; D055815:Young Adult