A PROSPECTIVE STUDY OF PATIENT-RELATED FACTORE INFLUENCING THE EFFICACY OF PERCUTANEOUS BALLOON CATHETER MTRAL VALVULOPLASTY BY A SET OF MODIFIED ECHOCARDIOGRAPHIC SCORE IN 115 SUBJECTS

摘要

The goal of the present study was to determine whether the patient-relatedfactors such as mitral valve morphological features influence the efficacyof percutaneous balloon catheter mitral valvuloplasty(PBMV)with Inoueballoon catheter,A set of modified echocardiographic total score(ETS),in which each score was assigned for each mitral valve morphologicalfeature such as valvular mobility,thickening,calcification or subvalvularthickening on a scare ranging from 1 to 4,used for a prospective cohortstudy of different fiTS in 115 subjects with mitral stenosis hut withoutsignificant mitral regurgitation.It was found that the efficacy of PBMVafter the procedure was significantly better in the low ETS(≤8 points)group(n=61,included 43 women;ages 18 to 57 years,mean 39)than inthe high ETS(8 points) group(n=54,included 37 women;ages 17 to 58years,mean 40)in mitral valve area (2.32+0.46 cm^2vs 1.87±0.37cm^2,p0.01),mean left atrial pressure(12±5 mmHg vs 18±7 mmHg,p0.01),mean mitral valve pressure gradient(4±1 mmHg vs 10±2 mmHg,p0.01),and left atrial dimension(34.9±5.2mm vs 41.2±6.9 mm,p0,01).In the low ETS group,mitral valve area was 2.30±0.45 cm^2(NS)and leftatrial dimension was 35.2±5.5mm(NS)at 12-30(24±7)monthsfollow-up.In contrast,in the high ETS group,mitral valve areadecreased to 1.58±0.36 cm^2(p0.01)and left atrial dimension incresed to45.2±7.4mm(p0.05) at 12-36 months follow-up.In addition,restenosiswas demonstrated in 12 of 54 patients(22%)with a high ETS but only in2 of 61 patients(3%.p0.01) with a low ETS at follow-up.Thus,thepatients with a morphological suitable valve for PBMV or a low ETS mayget a better efficacy from PBMV,and ETS mey be very useful in selectingpatient for the procedure.