Degenerative Mitral Stenosis Versus Rheumatic Mitral Stenosis

Pressman, Gregg S.; Ranjan, Rupesh; Park, Dong Hyuk; Shim, Chi Young; Hong, Geu Ru

doi:10.1016/j.amjcard.2020.02.020

Cited by 17 publications

(23 citation statements)

References 8 publications

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“…Despite this similarity between groups, DMS was associated with a larger MVA and lower mean TMPG compared with RMS. Consistent with our findings, Pressman et al recently reported in a retrospective cohort study that DMS is associated with a larger MVA relative to mean TMPG when compared to RMS 26 …”

Section: Discussionsupporting

confidence: 93%

“…The in a retrospective cohort study that DMS is associated with a larger MVA relative to mean TMPG when compared to RMS. 26 The DMSI proposed here denotes an increased velocity across the stenotic MV relative of the LVOT velocity. Similar to the continuity equation, the DMSI relies on the rule of conservation of mass.…”

Section: Ta B L E 1 Baseline Patient Characteristicsmentioning

confidence: 99%

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Dimensionless index of the mitral valve for evaluation of degenerative mitral stenosis

Oktay¹,

Riehl

Kachur³

et al. 2020

Echocardiography

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Purpose: Degenerative mitral stenosis (DMS) is an increasingly recognized cause of mitral stenosis. The goal of this study was to compare echocardiographic differences between DMS and rheumatic mitral stenosis (RMS), identify echocardiographic variables reflective of DMS severity, and propose a dimensionless mitral stenosis index (DMSI) for assessment of DMS severity. Methods: This is a single-center, retrospective cohort study. We included patients with at least mild MS and a mean transmitral pressure gradient (TMPG) ≥4 mm Hg. Mitral valve area by the continuity equation (MVA CEQ) was used as an independent reference. The DMSI was calculated as follows: DMSI = VTI LVOT / VTI MV. All-cause mortality data were collected retrospectively. Results: A total of 64 patients with DMS and 24 patients with RMS were identified. MVA CEQ was larger in patients with DMS (1.43 ± 0.4 cm 2) than RMS (0.9 ± 0.3 cm 2) by ~0.5 cm 2 (P = <.001), and mean TMPG was lower in the DMS group (6.0 ± 2 vs 7.9 ± 3 mm Hg, P = .003). A DMSI of ≤0.50 and ≤0.351 was associated with MVA CEQ ≤1.5 and MVA CEQ ≤1.0 cm 2 (P < .001), respectively. With the progression of DMS from severe to very severe, there was a significant drop in DMSI. There was a nonsignificant trend toward worse survival in patients with MVA CEQ ≤1.0 cm 2 and DMSI ≤0.35, suggesting severe stenosis severity. Conclusion: Our results show that TMPG correlates poorly with MVA in patients with DMS. Proposed DMSI may serve as a simple echocardiographic indicator of hemodynamically significant DMS.

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Section: Discussionsupporting

confidence: 93%

Section: Ta B L E 1 Baseline Patient Characteristicsmentioning

confidence: 99%

Dimensionless index of the mitral valve for evaluation of degenerative mitral stenosis

Oktay¹,

Riehl

Kachur³

et al. 2020

Echocardiography

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show abstract

“…Consistent with our findings, Pressman et al recently reported in a retrospective cohort study that DMS is associated with a larger MVA relative to mean TMPG when compared to RMS. 26 The DMSI proposed here denotes an increased velocity across the stenotic MV relative of the LVOT velocity. Similar to the continuity equation, the DMSI relies on the rule of conservation of mass.…”

Section: Discussionmentioning

confidence: 99%

Dimensionless Index of the Mitral Valve for Evaluation of Degenerative Mitral Stenosis

Oktay¹,

Riehl

Kachur³

et al. 2020

Preprint

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Purpose: Degenerative mitral stenosis (DMS) is an increasingly recognized cause of mitral stenosis. The goal of this study was to compare echocardiographic differences between DMS and rheumatic mitral stenosis (RMS), identify echocardiographic variables reflective of DMS severity, and propose a dimensionless mitral stenosis index (DMSI) for assessment of DMS severity. Methods: This is a single-center, retrospective cohort study. We included patients with at least mild MS and a mean transmitral pressure gradient (TMPG) [?] 4 mmHg. Mitral valve area by the continuity equation (MVACEQ) was used as an independent reference. The DMSI was calculated as follows: DMSI = VTILVOT / VTIMV. All-cause mortality data were collected retrospectively. Results: A total of 64 patients with DMS and 24 patients with RMS were identified. MVACEQ was larger in patients with DMS (1.43 ? 0.4 cm2) than RMS (0.9 ? 0.3 cm2) by~0.5 cm2 (p = <0.001) and mean TMPG was lower in the DMS group (6.0? 2 vs. 7.9?3 mmHg, p=0.003). A DMSI of ? 0.50 and [?] 0.351 were associated with MVACEQ [?] 1.5 and MVACEQ [?] 1.0 cm2 (p<0.001), respectively. With the progression of DMS from severe to very severe, there was a significant drop in DMSI. There was a non-significant trend towards worse survival in patients with MVACEQ [?] 1.0 cm2 and DMSI [?] 0.35, suggesting severe stenosis severity. Conclusion: Our results show that TMPG correlates poorly with MVA in patients with DMS. Proposed DMSI may serve as a simple echocardiographic indicator of hemodynamically significant DMS.

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“…Lyginant su kitomis širdies vožtuvų ydomis, dviburio vožtuvo stenozė nėra dažna [1]. Jos atvejų skaičius nedidelis, nes dažniausia dviburio vožtuvo stenozės priežastis yra reumatas, o sergamumas šia liga ekonomiškai išsivysčiusiose šalyse yra ženkliai sumažėjęs [2]. Degeneracinė dviburio vožtuvo stenozė dažnesnė vyresnio amžiaus žmonėms, taip pat sergantiems inkstų funkcijos nepakankamumu ar kalcio apykaitos sutrikimu [2].…”

Section: įVadasunclassified

“…Jos atvejų skaičius nedidelis, nes dažniausia dviburio vožtuvo stenozės priežastis yra reumatas, o sergamumas šia liga ekonomiškai išsivysčiusiose šalyse yra ženkliai sumažėjęs [2]. Degeneracinė dviburio vožtuvo stenozė dažnesnė vyresnio amžiaus žmonėms, taip pat sergantiems inkstų funkcijos nepakankamumu ar kalcio apykaitos sutrikimu [2]. Retais atvejais šią ydą gali imituoti kairiajame prieširdyje susiformavę dariniai -miksomos ar trombai.…”

Section: įVadasunclassified

Dviburio Vožtuvo Stenozę Imituojanti Kairiojo Prieširdžio Miksoma. Klinikinio Atvejo Analizė

Jakuškaitė¹,

Ereminienė²

2021

Health Sciences

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Pirminiai širdies navikai yra reti, daugiausia gerybiniai. Didžiąją jų dalį sudaro miksomos, kurios dažniausiai aptinkamos kairiajame prieširdyje. Neretai širdies miksomos ilgą laiką išlieka besimptomės ir aptinkamos atsitiktinių širdies vaizdinių tyrimų metu. Tačiau gali atsirasti simptomų, imituojančių dviburio vožtuvo stenozę. Aprašomas 37 metų paciento, patekusio į ligoninę dėl įtariamos bronchopneumonijos, atsiradusio stipraus dusulio, priverstinės sėdimosios padėties, karščiavimo ir bendro silpnumo, klinikinis atvejis. Atlikus dvimatį echokardiografinį tyrimą, aptiktas judrus darinys kairiajame prieširdyje, diastolės metu ženkliai stenozuojantis dviburį vožtuvą. Sumažėjus uždegiminiams rodikliams, pacientui buvo atlikta darinio rezekcija dirbtinės kraujo apytakos sąlygomis. Histologiškai patvirtinta širdies miksomos diagnozė. Paciento pooperacinis laikotarpis sklandus.

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Degenerative Mitral Stenosis Versus Rheumatic Mitral Stenosis

Cited by 17 publications

References 8 publications

Dimensionless index of the mitral valve for evaluation of degenerative mitral stenosis

Dimensionless index of the mitral valve for evaluation of degenerative mitral stenosis

Dimensionless Index of the Mitral Valve for Evaluation of Degenerative Mitral Stenosis

Dviburio Vožtuvo Stenozę Imituojanti Kairiojo Prieširdžio Miksoma. Klinikinio Atvejo Analizė

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