Lung Function and Severity of Mitral Stenosis

Abstract

Objective: To correlate the degree of severity in patients with rheumatic mitral stenosis to pulmonary function data and to their respiratory symptoms. Methods: Pulmonary function and the MCR questionnaire on respiratory symptoms were made in 43 patients with simple mitral stenosis (SMS), and 79 patients with advanced mitral stenosis scheduled for valve replacement surgery (MVR). Results: All the patients in the two groups had restrictive and obstructive patterns. They had reduced forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), peak expiratory flow rate, maximal flow after exhalation of 75, 50 and 25% of FVC and single-breath carbon monoxide diffusing capacity (DL_CO) and increased total airway resistance, resistance during expiration, and residual volume (RV). The SMS group tended toward more normal values. The MVR group had lower values for all the parameters, specially FVC, FEV₁, DL_CO and higher RV. The MVR group had a significantly higher prevalence of cough, phlegm and acute chest illness than the SMS group. Conclusion: The study confirmed the restrictive and obstructive pattern of pulmonary dysfunction in patients with rheumatic mitral stenosis which related with the severity of mitral stenosis and with respiratory symptoms.

Effect of Successful Percutaneous Transvenous Mitral Commissurotomy on Pulmonary Function

“…It is suggested that the increase in distribution of cardiac output after PTMC to respiratory muscle might change the force of diaphragm and other respiratory muscle causing increase in value of FEV 1 and FVC. 4 In a study, post procedural pulmonary function tests revealed significant improvement of FVC and TLC, i.e. disappearance of restrictive pattern on long term follow up.…”

“…Hypertrophied and hyperplastic airway smooth muscle and increased wall thickness are also heightened along with bronchial hyper-reactivity. 4 Thus, the effect is completely mechanical one and depends on the degree of stenosis of mitral valve. The major act of affray comes into account from several studies are reduction in pulmonary compliance ventilation-perfusion mismatch, reduction in diffusion capacity, increased "pulmonary capillary blood volume" and hyperventilation in exercise in relation to the oxygen uptake.…”

“…The major act of affray comes into account from several studies are reduction in pulmonary compliance ventilation-perfusion mismatch, reduction in diffusion capacity, increased "pulmonary capillary blood volume" and hyperventilation in exercise in relation to the oxygen uptake. 2,4,5 Majority of ventilatory functions impairment caused by hemodynamic alteration are mainly reversible. 2 In the present study, the pulmonary functions and echocardiography were done before and after PTMC in an order to observe the effect of PTMC on lung function test in severe mitral stenosis patients.…”

Pattern of Pulmonary Function Test in Patients with Severe Mitral Stenosis

“…5 The deterioration in lung function in mitral stenosis correlates with the severity of stenotic valves and the severity of respiratory symptoms. 6 A correlation is noted between vital capacity (VC) and the severity of dyspnoea in patients with mitral stenosis. It was reported that the degree of dyspnoea showed a closer relation to the height of pulmonary artery pressure and to VC, than to maximum breathing capacity in the pure mitral stenosis patients.…”