title: Effect of percutaneous mitral balloon valvuloplasty on right ventricular functions in mitral stenosis: short- and mid-term results.
abstract: OBJECTIVE
  To evaluate the short- and mid-term effects of percutaneous mitral balloon valvuloplasty (PMBV) on right ventricular functions in mitral stenosis.
  
  
  METHODS
  A prospective study was conducted in 61 patients who had mitral stenosis in normal sinus rhythm (68% female, age: 42±11-16 years). Right ventricular functions were measured before, immediately after, and at 3 months and 1 year after PMBV by conventional and tissue Doppler echocardiography imaging methods. Additionally, the patients were evaluated in two groups (PAP≥40 mm Hg, n: 46; PAP<40 mm Hg, n: 15) according to the systolic pulmonary artery that was measured by echocardiography prior to PMBV.
  
  
  RESULTS
  Post-PMBV mean gradient, pulmonary artery pressure (PAP), and left atrial size decreased significantly, and the mitral valve area increased significantly in both patient groups. This significance in pulmonary artery pressure was lost at 1 year. The significant post-PMBV increase in tricuspid annular point systolic excursion (TAPSE), systolic velocity, early diastolic velocity, and peak myocardial velocity during isovolumic contraction (IVV), indicating right ventricular functions, disappeared at 1 year. The significant post-PMBV decrease in myocardial performance index (MPI) and late diastolic velocity lost its significance at 1 year. No significant change was observed in myocardial acceleration during isovolumic contraction (IVA). The group with pulmonary hypertension demonstrated significance similar to the results of the overall group. Post-PMBV TAPSE, systolic velocity, early diastolic velocity, IVV, and IVA increased significantly, and this increase was maintained up to 1 year in the group without pulmonary hypertension. MPI and late diastolic velocity maintained their significantly decreased values up to 1 year.
  
  
  CONCLUSIONS
  The positive effect of PMBV on right ventricular function in the acute period decreases and even disappears in the mid-term in patients developing pulmonary hypertension. Intervention in the patients prior to the development of hypertension is very important for the improvement in right ventricular functions.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Atatürk University; Erzurum-Turkey. doktorsinaninci@gmail.com.
authors.forename: Sinan
authors.initials: S
authors.lastname: İnci
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Erol
authors.forename: Eftal Murat
authors.initials: EM
authors.lastname: Bakırcı
authors.forename: Hikmet
authors.initials: H
authors.lastname: Hamur
authors.forename: Hüsnü
authors.initials: H
authors.lastname: Değirmenci
authors.forename: Hakan
authors.initials: H
authors.lastname: Duman
authors.forename: Şule
authors.initials: Ş
authors.lastname: Karakelleoğlu
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000628:therapy*