title: Electrocardiographic P-wave Indices as a Useful Tool to Predict Successful Percutaneous Balloon Mitral Valvotomy in Patients with Mitral Stenosis.
abstract: Introduction : Patients with hemodynamically significant mitral stenosis (MS) have prolonged P-wave duration and increased P-wave dispersion (PWD) that decrease after successful percutaneous balloon mitral valvotomy (PBMV). The purpose of this study was to investigate if the changes in these indices may predict a successful procedure. Methods : Fifty two patients with MS in sinus rhythm underwent PBMV (90.4% female; mean age 38±10 years). Mitral valve area (MVA), valve score, mean diastolic mitral gradient (mMVG), mitral regurgitation severity, and systolic pulmonary artery pressure (sPAP) were evaluated by echocardiography before PBMV and repeated after one month. P-wave duration (Pmax /Pmin) and PWD were measured before and immediately after PBMV, at discharge, and at the end of the first month after discharge. Results : Among all procedures, 38 (73.1%) were defined as successful. Mean age, valve score, mMVG, and MVA before PBMV were similar for both groups. MVA was significantly greater in the successful PBMV group (1.65±0.27 vs. 1.41±0.22; P= 0.003). sPAP was reduced after PBMV in all patients and there were no significant differences in the mean sPAP before and after PBMV in both successful and unsuccessful groups. Pmax and PWD were significantly decreased immediately after the procedure (P= 0.035), the next day (P= 0.005) and at one month (P= 0.002) only in patients with successful PBMV. Pmin did not change significantly in either group. Conclusion : Only is successful PBMV associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV.
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Kazemi
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Rostami
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Aslanabadi
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Samad
authors.initials: S
authors.lastname: Ghaffari
keywords: Mitral Stenosis; P-wave Dispersion; P-wave Duration
references.citation: Int J Cardiol. 2005 Jun 22;102(1):33-7
references.pmid: 15939096
references.citation: Pacing Clin Electrophysiol. 2000 Jul;23(7):1109-12
references.pmid: 10914366
references.citation: Clin Cardiol. 2011 Jun;34(6):401-6
references.pmid: 21538391
references.citation: Cardiovasc Res. 2010 Mar 1;85(4):711-8
references.pmid: 19939964
references.citation: Cathet Cardiovasc Diagn. 1994 Dec;33(4):315-6
references.pmid: 7889548
references.citation: J Am Coll Cardiol. 1995 Aug;26(2):497-502
references.pmid: 7608455
references.citation: Pacing Clin Electrophysiol. 1999 Oct;22(10):1532-8
references.pmid: 10588156
references.citation: Circulation. 1997 Nov 18;96(10):3443-9
references.pmid: 9396440
references.citation: Am J Cardiol. 1984 Oct 1;54(7):755-61
references.pmid: 6486024
references.citation: J Am Coll Cardiol. 1996 Aug;28(2):371-5
references.pmid: 8800112
references.citation: Am Heart J. 1998 May;135(5 Pt 1):733-8
references.pmid: 9588401
references.citation: J Am Coll Cardiol. 1999 Jul;34(1):49-54
references.pmid: 10399991
references.citation: Circulation. 1976 Oct;54(4):553-7
references.pmid: 134852
references.citation: Br Heart J. 1988 Oct;60(4):299-308
references.pmid: 3190958
references.citation: Pacing Clin Electrophysiol. 2008 Dec;31(12):1620-4
references.pmid: 19067816
references.citation: Am J Cardiol. 2002 Mar 1;89(5):607-9
references.pmid: 11867052
references.citation: Am J Cardiol. 2000 Apr 1;85(7):896-9, A10
references.pmid: 10758937
references.citation: Eur Heart J. 1998 May;19(5):794-800
references.pmid: 9717015
references.citation: Circ Arrhythm Electrophysiol. 2009 Feb;2(1):72-9
references.pmid: 19808445
references.citation: Am Heart J. 2004 Apr;147(4):741-5
references.pmid: 15077093
references.citation: Circulation. 2001 May 29;103(21):E111-1
references.pmid: 11382743
references.citation: Am J Cardiol. 2005 Apr 15;95(8):989-91
references.pmid: 15820172
references.citation: J Am Coll Cardiol. 1986 Sep;8(3):711-24
references.pmid: 2943786
references.citation: Pacing Clin Electrophysiol. 2000 Mar;23(3):352-8
references.pmid: 10750136