Impedance Cardiography for Demonstrating Procedural Efficacy of Percutaneous Mitral Balloon Valvuloplasty

Abstract

A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Impedance Cardiography (ICG) method, facilitates measuring hemodynamic parameters indirectly by recording thoracic impedance variations induced by cyclic changes in blood flow. The aim of this study is to evaluate alterations in hemodynamic parameters obtained by impedance cardiography (ICG) in addition to conventional echocardiographic and catheterization data after percutaneous mitral balloon valvuloplasty (PMBV). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 18 patients with severe rheumatic mitral stenosis to whom PMBV had been performed were included in this study. Impedance cardiographic measurements were performed in addition to routine echocardiographic examination and invasive left atrial and pulmonary arterial pressure recordings before and after the procedure. Cardiac output was calculated with direct Fick method before PMBV. Average values of several measurements were used to obtain the most accurate results for atrial fibrillation patients in the study group. R Re es su ul lt ts s: : Following successful PMBV, in impedance cardiographic evaluation an increase in cardiac output (4.69±1.46 and 5.68±1.3 l/min, before and after PMBV, respectively, p<0.001) and cardiac index (2.72±0.81 and 3.29±0.73 l/min/m 2 , before and after PMBV, respectively, p<0.001) an evident prolongation in ejection period (246.8±40.3 and 275.2±32.1 msec, before and after PMBV, respectively, p<0.001); and a statistically significant reduction in pre-ejection period (103.7±41.8 and 82.7±16.8 msec, before and after PMBV, respectively, p=0.033), and thoracic fluid content (34.3±11.2 and 27.7±5.31/kΩ, before and after PMBV, respectively, p=0.037) was observed. There was a strong correlation between preprocedural cardiac output calculations of ICG and direct Fick method (r:0.89, p<0.001). C Co on nc cl lu us si io on n: : In addition to the conventional methods, serial recordings of impedance cardiographic outputs may yield beneficial information for the assessment of PMBV efficacy. As a non-invasive and easily applicable method, it might be utilized during in-hospital follow-up. K Ke ey y W Wo or rd ds s: : Cardiography, impedance; mitral valve stenosis; mitral valve annuloplasty Ö ÖZ ZE ET T A Am ma aç ç: : Empedans kardiyografi (EmKG), atımdan atıma değişen kan akımının oluşturduğu göğüs empedans değişikliklerini kaydederek hemodinamik parametrelerin dolaylı olarak ölçülmesine imkân tanıyan bir yöntemdir. Bu çalışmada, perkütan mitral balon valvuloplasti (PMBV) sonrası rutin olarak değerlendiri-len ekokardiyografi ve kateterizasyon verilerine ek olarak; EmKG ile elde edilen hemodinamik göstergeler-deki değişimlerin incelenmesi amaçlandı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya PMBV uygulanan 18 ciddi mitral darlığı hastası alındı. İşlem öncesi ve sonrasında, rutin ekokardiyografik inceleme ve invaziv sol atriyum ve pulmoner arter basınç kayıtlarına ek olarak EmKG ölçümleri yapıldı. PMBV öncesi kardiyak debi Fick yön-temiyle hesaplandı. Ça...