title: Correlation of pulmonary capillary wedge pressure with left atrial pressure in patients with mitral stenosis undergoing balloon valvotomy.
abstract: OBJECTIVE
  We sought to evaluate the correlation between PCWP and LAP and to compare transmitral gradients obtained with LAP and PCWP in MS, before and after balloon mitral valvotomy (BMV).
  
  
  METHODS
  Consecutive patients with MS for BMV were included in this prospective cohort study. Simultaneous PCWP and LAP were recorded followed by simultaneous left atrium-left ventricular (LA-LV) and pulmonary capillary wedge pressure-left ventricular (PCWP-LV) gradients before and after BMV.
  
  
  RESULTS
  There were 30 patients with a mean age of 41 yrs (males 10 (33.3%), females 20 (66.7%)). There was no significant difference between mean LAP and mean PCWP before BMV (21.3mmHg and 22.3mmHg, respectively) or after BMV (15.3mmHg and 17.3mmHg, respectively). There was excellent correlation between mean PCWP and mean LAP before BMV (r=0.95) (p<0.001) and after BMV (r=0.85) (p<0.001). The phasic components of the pressures (a and v waves) of LAP and PCWP also showed good correlation before and after BMV. Further, transmitral gradients assessed by LA-LV and PCWP-LV pressures showed excellent correlation before BMV (r=0.95) (p<0.001) and after BMV (r=0.95) (p<0.001).
  
  
  CONCLUSIONS
  In patients with MS undergoing balloon valvotomy, PCWP shows good correlation with LAP. Transmitral gradients obtained with PCWP and LAP also correlate well after correction of phase lag in PCWP tracing. Hence, PCWP can be used for reliable measurement of transmitral gradient.
authors.affiliation: Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India. Electronic address: vinayakumard@gmail.com.
authors.forename: Desabandhu
authors.initials: D
authors.lastname: Vinayakumar
authors.affiliation: Senior Resident, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Uppalakal
authors.initials: U
authors.lastname: Bijilesh
authors.affiliation: Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: C G
authors.initials: CG
authors.lastname: Sajeev
authors.affiliation: Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Gopalan Nair
authors.initials: GN
authors.lastname: Rajesh
authors.affiliation: Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Cicy
authors.initials: C
authors.lastname: Bastion
authors.affiliation: Additional Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: P
authors.initials: P
authors.lastname: Kadermuneer
authors.affiliation: Assistant Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: V
authors.initials: V
authors.lastname: Haridasan
authors.affiliation: Assistant Professor, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Dolly
authors.initials: D
authors.lastname: Mathew
authors.affiliation: Assistant Professor, Department of Community Medicine, Government Medical College, Kozhikode, Kerala, India.
authors.forename: Biju
authors.initials: B
authors.lastname: George
authors.affiliation: Professor and Head, Department of Cardiology, Government Medical College, Kozhikode, Kerala, India.
authors.forename: M N
authors.initials: MN
authors.lastname: Krishnan
mesh_terms: D000328:Adult; D062185:Atrial Pressure / Q000502:physiology*; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D013997:Time Factors
keywords: Balloon mitral valvotomy; Left atrial pressure; Pulmonary capillary wedge pressure