title: [The impact of mitral valve morphology on the short and long-term outcome post percutaneous balloon mitral valvuloplasty in patients with mitral valve stenosis].
abstract: OBJECTIVE
  To investigate the short and long-term outcome post percutaneous balloon mitral valvuloplasty (PBMV) in mitral valve stenosis patients with different mitral valve morphology.
  
  
  METHODS
  Mitral valve morphology was graded according to the Wilkins scoring system, 385 eligible patients were divided into echocardiographic scores > 8 group (n = 125) and ≤ 8 group (n = 260). Patients were followed up after PBMV according to the improved Inoue method.
  
  
  RESULTS
  PBMV was successful in 370 patients, the success rate of PBMV in > 8 group was significantly lower than in ≤ 8 group (92.8% vs. 97.7%, P < 0.05). Hemodynamic parameters improved significantly in both groups (all P < 0.05) at 6 months post PBMV. Compared to pre-PBMV, improvement on left atrial mean pressure [(14.22 ± 5.02) mm Hg vs. (15.44 ± 5.19) mm Hg (1 mm Hg = 0.133 kPa)], pulmonary artery systolic pressure [(26.13 ± 9.27) mm Hg vs. (31.93 ± 9.98) mm Hg], mitral valve gradient [(9.21 ± 4.11) mm Hg vs. (10.16 ± 4.21) mm Hg] and area of mitral valve orifice [(1.02 ± 0.15) cm(2) vs. (1.20 ± 0.22) cm(2)] post PBMV was less in > 8 group (116 cases) than those in ≤ 8 group (254 cases, all P < 0.05). Three hundreds and fifty three patients were followed up for (78 ± 20) months. Echocardiographic parameters post PBMV improved significantly in both groups compared with the pre-PBMV values during follow-up (all P < 0.05). However, left atrial mean pressure, pulmonary artery systolic pressure, mitral valve gradient and area of mitral valve orifice in > 8 group (108 cases) improved less than those in ≤ 8 group (245 cases) [(13.28 ± 5.06) mm Hg vs. (14.77 ± 5.17) mm Hg, (21.19 ± 9.17) mm Hg vs. (28.92 ± 9.91) mm Hg, (7.30 ± 4.40) mm Hg vs. (9.16 ± 4.28) mm Hg, (0.92 ± 0.17) cm(2) vs. (1.07 ± 0.20) cm(2); all P < 0.05]. The incidence of mitral restenosis was also significantly higher in > 8 group than in ≤ 8 group (20.4% vs. 8.2%, P < 0.05).
  
  
  CONCLUSIONS
  The mitral valve morphology played a key role on the outcome post PBMV in patients with mitral valve stenosis. Patients with lower echocardiographic scores benefit more from PBMV than patients with higher echocardiographic scores.
authors.affiliation: Department of Cardiology, Second People's Hospital of Pingdingshan, Pingdingshan 467000, China. zlpds@163.com
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Xiu-yu
authors.initials: XY
authors.lastname: Yue
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D063126:Balloon Valvuloplasty / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult