title: Left atrium reverse remodeling in patients with mitral valve stenosis after percutaneous valvuloplasty: a 2- and 3-dimensional echocardiographic study.
abstract: OBJECTIVE
  The left atrium is clinically relevant in patients with mitral valve stenosis. The objective of this study was to analyze the effects of percutaneous balloon valvuloplasty on left atrium volumes and the left atrium emptying fraction in symptomatic mitral valve stenosis patients using 2-dimensional and real-time 3 -dimensional transthoracic echocardiography.
  
  
  METHODS
  We carried out a prospective study of 28 consecutive symptomatic mitral valve stenosis patients, aged 22-72 (39 [11.5]) years, 24/28 (85.6%) women, who underwent to percutaneous balloon valvuloplasty between March 2009 and May 2011. Patients underwent 2- and 3-dimensional transthoracic and transesophageal echocardiography (atrial fibrillation) and invasive mitral valve area measurement. Echocardiographic analysis was performed before, 72 h after and 12 months after percutaneous balloon valvuloplasty. The following parameters were analyzed: a) mitral valve area (2-dimensional planimetry, pressure half-time, 3-dimensional echocardiography, invasive hemodynamic measurement); b) indexed left atrium maximum and indexed minimum volumes, and c) left atrium emptying fraction.
  
  
  RESULTS
  The 3-dimensional parameters of the mitral valve stenosis patients before and 72 h and 12 months after percutaneous balloon valvuloplasty were as follows: a) mitral valve area: 0.9 (0.1) cm(2); 1.8 (0.2) cm(2) (P<.001); 1.7 (0.2) cm(2) (P<.001); b) left atrium maximum volumes: 49.9 (12) mL/m(2); 42 (11.4) mL/m(2) (P<.001); 40.3 (10.2) mL/m(2) (P<.001), and c) left atrium emptying fraction: 30.1 (9.4%); 40.6 (7.4%) (P<.001); 44.1 (8%) (P<.001), respectively.
  
  
  CONCLUSIONS
  In symptomatic mitral valve stenosis patients who underwent percutaneous balloon valvuloplasty analysis by 2- and 3-dimensional echocardiography, improvements in left atrium reverse remodeling and left atrium emptying fraction were observed 72 h and 12 months after the procedure.
authors.affiliation: InCor, São Paulo University Medical School, Brasil. mluiz766@terra.com.br
authors.forename: Marcelo L Campos
authors.initials: ML
authors.lastname: Vieira
authors.forename: Murilo C
authors.initials: MC
authors.lastname: Silva
authors.forename: Camila R
authors.initials: CR
authors.lastname: Wagner
authors.forename: Luis A
authors.initials: LA
authors.lastname: Dallan
authors.forename: Luis J
authors.initials: LJ
authors.lastname: Kajita
authors.forename: Wercules A
authors.initials: WA
authors.lastname: Oliveira
authors.forename: Nelson
authors.initials: N
authors.lastname: Samesina
authors.forename: Viviane T
authors.initials: VT
authors.lastname: Hotta
authors.forename: Wilson
authors.initials: W
authors.lastname: Mathias
authors.forename: Guilherme
authors.initials: G
authors.lastname: Spina
authors.forename: Luis
authors.initials: L
authors.lastname: Cardoso
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Pastore
authors.forename: Flávio
authors.initials: F
authors.lastname: Tarasoutchi
authors.forename: Max
authors.initials: M
authors.lastname: Grinberg
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome