The acute effect of percutaneous mitral balloon valvuloplasty on atrial electromechanical delay and P-wave dispersion in patients with mitral stenosis.

摘要

BACKGROUND AND AIM OF THE STUDY: The predisposition to atrial fibrillation (AF) in mitral stenosis (MS) has been demonstrated with several electrocardiographic (increased P-wave dispersion) and echocardiographic parameters (atrial electromechanical delay). Despite the improvement in P-wave dispersion after percutaneous mitral balloon valvuloplasty (PMBV), the changes in echocardiographic parameters related to AF risk are unknown. In this study we aimed to investigate the acute effect of PMBV on atrial electromechanical delay (EMD) assessed by tissue Doppler echocardiography in addition to electrocardiographic parameters. MATERIALS AND METHODS: This single-center study consisted of 30?patients with moderate or severe MS (23?females and seven males, aged 36.5?±?8.5?years, with a mean MVA of 1.1?±?0.2?cm(2)) who underwent successful PMBV without complication at our clinic and 20 healthy volunteers from hospital staff as a control group (16?females and four males, aged 35.4?±?6?years). We compared the two groups in regard to clinical, electrocardiographic and echocardiographic features. The patients with MS were also evaluated after PMBV within 72?h of the procedure. The P-wave dispersion was calculated from12-lead ECG. Interatrial and intra-atrial EMDs were measured by tissue Doppler echocardiography. These ECG and echocardiographic parameters after PMBV were compared with previous values. RESULTS: The maximum P-wave duration (138?±?15 vs. 101?±?6?ms, p?