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1.
Background:
Symptomatic mitral restenosis develops in up to 21% of patients after percutaneous balloon mitral valvotomy (PBMV), and most of these patients undergo mitral valve replacement (MVR).Hypothesis:
Repeating PBMV (re‐PBMV) might be an effective and less‐invasive treatment for these patients.Methods:
Forty‐seven patients with post‐PBMV mitral restenosis and unfavorable valve characteristics were assigned either to re‐PBMV (25 cases; mean age 40.7 ± 11 y, 76% female) or MVR (22 cases; mean age 47 ± 10 y, 69% female) at 51 ± 33 months after the prior PBMV. The mean follow‐up was 41 ± 32 months and 63 ± 30 months for the re‐PBMV and MVR groups, respectively.Results:
The 2 groups were homogenous in preoperative variables such as gender, echocardiographic findings, and valve characteristics. Patients in the MVR group were older, with a higher mean New York Heart Association functional class, mean mitral valve area, mitral regurgitation grade, and right ventricular systolic pressure (P = 0.03), and more commonly were in AF. There were 3 in‐hospital deaths (all in the MVR group) and 4 during follow‐up (3 in the MVR group and 1 in the re‐PBMV group). Ten‐year survival was significantly higher in re‐PBMV vs MVR (96% vs 72.7%, P<0.05), but event‐free survival was similar (52% vs 50%, P = 1.0) due to high reintervention in the re‐PBMV group (48% vs 18.1%, P = 0.02).Conclusions:
In a population with predominantly unfavorable characteristics for PBMV, short‐ and long‐term outcomes are both reasonable after re‐PBMV with less mortality but requiring more reinterventions compared with MVR. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose. 相似文献2.
Suzanne Elize van Wijngaarden Vasileios Kamperidis Ibtihal Al-Amri Frank van der Kley Martin J. Schalij Nina Ajmone Marsan Jeroen J. Bax Victoria Delgado 《Journal of cardiac failure》2018,24(3):137-145
Aims
To evaluate the effects of MitraClip on left ventricular (LV) and left atrial (LA) myocardial wall stress as assessed with the use of N-terminal pro–B-type natriuretic peptide (NT-proBNP) and strain imaging.Methods and results
Sixty-five patients with symptomatic moderate and severe mitral regurgitation (MR; age 75?±?9 y, 57% male, 89% functional MR) treated with the use of MitraClip were evaluated. Patients were divided according to 6-month NT-proBNP tertiles. Changes in echocardiographic parameters over 6 months were assessed. Reductions in LV end-diastolic volumes (178?±?77?mL to 170?±?79?mL; P?=?.045) and LV end-systolic volumes (120?±?70?mL to 111?±?69?mL; P?=?.040) were observed in the overall population. Interestingly, low–NT-proBNP–tertile patients showed slight improvements in LV and LA longitudinal strain, whereas high–NT-proBNP–tertile patients showed impairment.Conclusions
Although MitraClip induces hemodynamic unloading in patients with predominantly functional MR, myocardial wall stress is not consistently improved. In patients with reduced NT-proBNP, improvements in LA volume index and LV and LA strains were observed. Patients who showed an increase in NT-proBNP exhibited impairment in LV and LA strain, suggesting an increase of myocardial wall stress. 相似文献3.
Maha H. El Sebaie M.N. Abdelatti A.A. Zarea A.M. Farag A.A. Hashem A.M. Fadel 《The Egyptian Heart Journal》2017,69(1):13-20
Background
A full understanding of the geometry of the nonplanar saddle-shaped mitral annulus can provide valuable information regarding the pathophysiology of mitral regurgitation (MR).Aim of the work
To investigate mitral annular geometric deformities using three-dimensional echocardiography among patients with ischemic coronary illness with and without mitral regurgitation.Methods
Three-dimensional transesophageal echocardiographic data were acquired intraoperatively from patients with ischemic heart disease with or without associated mitral regurgitation who experienced coronary artery bypass grafting and normal control subjects. The mitral annulus was analyzed for differences in geometry using QLAB software.Results
Left ventricular ejection fraction was reduced in patients with ischemic heart disease and MR (n = 21; Group 1) and without MR (n = 7; Group 2) compared with that in normal subjects (n = 14; Group 3) (43.4% ± 11.8% and 35.9% ± 13.6% vs. 52.6% ± 9.3%, respectively; p = 0.015). Mitral annular height and mitral annular saddle-shaped nonplanarity were significantly lower in Group 1 compared to Group 2 and Group 3 (6.00 ± 1.07 mm, 7.96 ± 0.93 mm and 8.31 ± 1.12 mm; p < 0.0001) and (0.19 ± 0.04, 0.26 ± 0.04 and 0.26 ± 0.03; p < 0.0001) respectively while mitral annular ellipsicity and Mitral valve tenting volume were significantly higher in the same group (1) (114.82% ± 22.47%, 100.21% ± 9.87% and 97.29% ± 14.37%; p = 0.0421) and (2.73 ± 1.11, 2.20 ± 1.39 and 0.87 ± 0.67) respectively. Vena contracta diameter was inversely correlated with the mitral annular height (r = ?0.82; p < 0.0001) and saddle-shaped nonplanarity of the annulus (r = ?0.68; p < 0.0001).Conclusion
Among patients with ischemic heart disease, there are significant increases in mitral valve tenting volume and height, and those with mitral regurgitation exhibited a reduced mitral annular height, a shallower saddle shape annulus and losses of ellipsicity of the annulus. 相似文献4.
目的 观察不同瓣膜形态的二尖瓣狭窄患者行经皮球囊二尖瓣成形术的近远期疗效.方法 根据Wilkins超声二尖瓣形态学积分,将385例二尖瓣狭窄患者分为＞8分组(125例)和≤8分组(260例).均采用改良Inoue法对患者行经皮球囊二尖瓣成形术.术后进行随访,并比较两组患者的临床疗效.结果 经皮球囊二尖瓣成形术成功370例,＞8分组经皮球囊二尖瓣成形术的成功率低于≤8分组(92.8％比97.7％,P＜0.05).术后6个月,两组患者各项超声心动图检查指标均较术前显著改善(均P＜0.05);与≤8分组(254例)比较,＞8分组(116例)经皮球囊二尖瓣成形术后左心房平均压、肺动脉收缩压、跨瓣压差及二尖瓣瓣口面积的改变值均较小[分别为(14.22±5.02)mm Hg(1 mm Hg=0.133 kPa)比(15.44±5.19) mm Hg、(26.13±9.27) mm Hg比(31.93±9.98)mm Hg、(9.21±4.11)mm Hg比(10.16 ±4.21)mm Hg和(1.02±0.15)cm2比(1.20±0.22)cm2,均P＜0.05].经皮球囊二尖瓣成形术成功且完成远期随访[(78±20)个月]的患者共353例,两组患者各项超声心动图检查指标均较术前显著改善(均P＜0.05);与≤8分组(245例)比较,＞8分组(108例)左心房平均压、肺动脉收缩压、跨瓣压差及二尖瓣瓣口面积的改变值均较小[分别为(13.28±5.06) mm Hg比(14.77±5.17)mm Hg、(21.19±9.17) mm Hg比(28.92±9.91) mm Hg、(7.30±4.40)mm Hg比(9.16±4.28)mm Hg和(0.92±0.17)cm2比(1.07±0.20)cm2,均P＜0.05],且再狭窄发生率较高(20.4％比8.2％,P＜0.05).结论 二尖瓣瓣膜形态是决定经皮球囊二尖瓣成形术疗效的关键因素之一.对于超声二尖瓣形态学积分低的患者,经皮球囊二尖瓣成形术成功率较高,术后近期及远期随访疗效较好,再狭窄发生率较低,治疗方案可优先选择经皮球囊二尖瓣成形术. 相似文献
5.
张领 《中华心血管病杂志》2009,37(1)
目的 观察经皮球囊二尖瓣成形术后再狭窄的患者,行再次经皮球囊二尖瓣成形术的远期疗效.方法 39例经皮球囊二尖瓣成形术后再狭窄的患者,全部采用改良Inoue法,再次行经皮球囊二尖瓣成形术,并进行远期疗效随访.结果 39例患者再次行经皮球囊二尖瓣成形术,成功36例(成功率为92.3%).再次经皮球囊二尖瓣成形术成功后,患者临床症状及部分血流动力学指标(左心房平均压、二尖瓣瓣口面积、跨瓣压差及肺动脉收缩压)明显改善[分别为(24.50±6.54)mm Hg比(9.66±4.21)mill Hg(1 mm Hg=0.133 kPa),(1.05±0.19)cm2比(2.23±0.22)cm2,(17.03±4.52)mm Hg比(7.79±4.07)mm Hg,(58.12±12.68)mm Hg比(31.45±10.02)mm Hg,P均＜0.05];而左心房内径无明显改变[(4.71±0.75)cm比(4.07±0.69)cm,P＞0.05]. 36例患者再次经皮球囊二尖瓣成形术后随访12～146(69±23)个月,远期随访可见二尖瓣瓣121面积仍明显大于术前[(2.02±0.21)cm2比(1.05±0.19)cm2,P＜0.05],跨瓣压差明显小于术前[(9.15±4.11)mm Hg比(17.03±4.52)mm Hg,P＜0.05],且均与近期随访结果相近似[分别为(2.02±0.21)cm2比(2.23±0.22)cm2,(9.15±4.11)mm Hg比(7.79±4.07)mm Hg,P均＞0.05];而左心房内径仍无明显改变[(4.13±0.71)cm比(4.07±0.69)cm,P＞0.05].远期随访期间,大多数患者心功能及生活质量均明显改善.结论 对于经皮球囊二尖瓣成形术后再狭窄的患者,只要病例选择恰当,手术操作正确,再次行经皮球囊二尖瓣成形术的近期及远期疗效均佳. 相似文献
6.
目的探讨运动负荷后脉搏血氧饱和度(SpO2)对重度二尖瓣狭窄经皮腔内球囊二尖瓣成形术(PBMV)疗效的评价作用。方法40例风湿性心脏病重度二尖瓣狭窄患者,分别于PBMV前3d内及术后2周~4周行超声心动图检查,并检测症状限制性次极量活动平板试验运动负荷后即刻SpO2,PBMV术中检测球囊扩张前后血流动力学改变。结果PBMV后各项检测指标均有显著改善;无论术前与术后,运动负荷后即刻SpO2在不同临床心功能级别之间比较有显著差异(P<0.05),随着临床心功能的改善,运动负荷后即刻SpO2明显提高(组间多重比较P<0.05),超声心动图指标二尖瓣口面积(MVA)及左心房内径(LAD)在不同临床心功能级别之间比较无明显差异(P>0.05);无论术前与术后,运动负荷后即刻SpO2与MVA及LAD均无明显相关性(r<0.2,P>0.05)。结论运动负荷后SpO2能够较好地反映PBMV疗效,是评价重度二尖瓣狭窄PBMV后患者实际生活能力的一项有价值的检查手段。 相似文献
7.
Mohammad M. Al-Daydamony Tamer M. Moustafaa 《Journal of the Saudi Heart Association》2017,29(4):276-282
Background
Pulmonary hypertension is a common complication of rheumatic mitral stenosis (MS). Patients with similar mitral valve (MV) areas may have different pulmonary artery pressures. Net atrioventricular compliance (Cn) was found to play an important role in the development of pulmonary hypertension.Aim
To test the value of Cn in predicting persistent pulmonary artery hypertension (PPAH) after percutaneous mitral balloon commissurotomy (PMBC).Patients and Methods
Eighty patients with severe MS, suitable for PMBC were included in the study. We excluded patients with contraindication to PMBC, atrial fibrillation, failure of PMBC, and restenosis. All patients had undergone electrocardiography, echocardiography with measurement of MV area, systolic pulmonary artery pressure (SPAP), and Cn, PMBC, and follow-up echocardiography.Results
Patients were divided into two groups: Group I: Cn < 4.2 mL/mmHg (36 patients), Group II: Cn ≥ 4.2 mL/mmHg (44 patients). Group I patients had significantly higher SPAP, and significantly lower SPAP reduction. Sensitivity of Cn < 4.2 mL/mmHg in prediction of PPAH was 88.9%, specificity was 88.6%, and accuracy was 88.8%. Independent predictors for PPAH were baseline Cn (p = 0.0027), and Cn improvement after PMBC (p = 0.0085). There was a significant negative correlation between Cn and baseline SPAP (r = ?0.349, p = 0.0015), and a significant positive correlation between Cn and percent SPAP reduction (r = 0.617, p < 0.00001).Conclusion
Measuring Cn can predict PPAH in MS patients after PMBC. It also may add value in evaluating MS patients undergoing PMBC and may help in predicting their prognosis. 相似文献8.
Al-Shimaa Mohamed Sabry Heba Abd El-Kader Mansour Tarek Helmy Abo El-Azm Shimaa Ahmed Mostafa Basant Samy Zahid 《The Egyptian Heart Journal》2017,69(4):281-288
Objectives
Detection of the echocardiographic predictors of post-operative atrial fibrillation in patients with rheumatic mitral valve disease undergoing mitral valve replacement.Methods
The study included 50 patients with rheumatic mitral valve disease undergoing mitral valve replacement. Preoperative assessment included standard two-dimensional echocardiography to assess LA diameter, volume, and emptying fraction, LV volume and ejection fraction. TDI derived velocity, strain of the left atrium and speckle tracking to assess left ventricular function then postoperative follow up for 1 month for occurrence of atrial fibrillation.Results
The incidence of postoperative AF was 44%; these patients were significantly older (P = 0.001) and show higher prevalence of DM (P = 0.001) and HTN (P = 0.001). Also, LA diameters (antero-posterior, transverse and longitudinal) and LA volumes (maximal and minimal) were increased (P < 0.001), but no difference in LA emptying fraction (P > 0.05). Systolic LA strain and left ventricular global longitudinal strain were significantly reduced in those patients (P value <0.001). Echocardiographic predictors of AF were LA systolic strain (P value <0.001) and LV global longitudinal strain (P value = 0.003). Cutoff value for systolic LA strain ≤23 had sensitivity 90.91% and specificity 93.33% in predicting POAF. While, left ventricular global longitudinal strain ≤?14.9% had sensitivity 63.6% and specificity 100.0% in predicting AF.Conclusion
LA systolic strain and LV global longitudinal strain were significant predictors of POAF. Echocardiographic parameters can identify patients at greater risk of developing POAF who can benefit from preventive measure and guide the selection of prosthesis. 相似文献9.
Spontaneous left atrial echo contrast,mitral annular systolic velocity,and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty 
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下载免费PDF全文 Tirumala Naresh Arava DM Rajasekhar Durgaprasad DM Vanajakshamma Velam DM Obul Reddy Gajjala DM Vinod K. Neelam MD Suchitra N. Manohar MD 《Echocardiography (Mount Kisco, N.Y.)》2018,35(2):162-169
Background
Thromboembolic events are the major cause of morbidity and mortality in patients with mitral stenosis (MS). This study aims to investigate left atrial spontaneous echo contrast (LA SEC), mitral annular systolic velocity (Sa‐wave), left atrial appendage (LAA) late emptying velocity (LAAEV), LAA filling velocity (LAAFV) pre‐ and postpercutaneous balloon mitral valvuloplasty (PBMV) for MS. This also aims to study the association of LA SEC with inflammatory marker, high‐sensitivity C‐reactive protein (hs‐CRP) in MS.Methods
The study population consisted of 100 patients with symptomatic MS with sinus rhythm who underwent PBMV. Transthoracic echo (TTE), tissue Doppler imaging (TDI), and transesophageal echo (TEE) examinations were carried out before and 14 days following PBMV. High‐sensitivity C‐reactive protein (hs‐CRP) was measured at the time of admission.Results
The mean age was 33.2 ± 10.3 years with female preponderance (71%). There was a decrease in SEC grading, (pre‐PBMV 2.8 ± 0.9 and post‐PBMV 0.4 ± 0.1; P < .01), increase in LAAEV (pre‐PBMV 23.0 ± 7.9 cm/s and post‐PBMV 40.9 ± 8.4 cm/s; P < .01), and LAAFV (pre‐PBMV 31.8 ± 9.3 cm/s and post‐PBMV 51.2 ± 8.7 cm/s; P < .01).A significant positive correlation was present between LAAEV and Sa‐wave (r = .52, P < .01). Correlation between hs‐CRP and SEC was positive and significant (r = .33, P < .01). Optimal cutoff value of hs‐CRP for prediction of moderate to dense SEC was >2.3 mg/dL, the cutoff value of Sa‐wave was≤ 5.5 cm/s for prediction of the presence of inactive LAA (LAAEV < 25 cm/s).Conclusion
Mitral annular systolic velocity (Sa‐wave) is an independent predictor of inactive LAA and a useful parameter in estimating inactive LAA in MS. Sa‐wave and hs‐CRP are independent predictors for SEC. PBMV improves LAA function in patients with MS. 相似文献10.
目的 探讨经皮球囊二尖瓣成形术(PBMV)治疗二尖瓣狭窄的疗效和术后左心房重构的可控影响因素.方法 选取我院1998年3月至2002年6月行PBMV的二尖瓣狭窄患者96 例.收集术前、术后1周和术后4～6年超声心动图、12导联心电图等临床资料进行回顾性分析.采用多元逐步回归方法分析影响术后左心房重构的可控临床因素.结果 PBMV术前左心房内径与术后1周比较差异无统计学意义[(44.6±6.6)cm比(42.8±6.5)cm,P>0.05];术后4～6年左心房内径为(47.2±5.7)cm,均大于术前和术后1周(P均<0.05).与术前比较,术后1周和4～6年二尖瓣口面积均较大[(2.02±0.43)cm2和(1.98±0.36)cm2比(1.06±0.32)cm2,P均<0.05].术后1周和术后4～6年心功能Ⅰ和Ⅱ级(纽约心脏病学会分级)患者比例均高于术前(P<0.01).多元回归分析显示,与术后4～6年左心房内径相关的可控因素包括术后4～6年收缩压水平、术后1周二尖瓣口面积、术前心房颤动、术前Wilkins积分≤8分,术前左心房内径(P均<0.05).结论 PBMV治疗二尖瓣狭窄的近期效果明显.术后4～6年收缩压水平、术后1周二尖瓣口面积、术前心房颤动、术前Wilkins积分≤8分、术前左心房内径是影响术后左心房内径的重要因素.Abstract： Objective To observe the outcome and assess related factors affecting left atrial remodeling after percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral valve stenosis. Methods From March 1998 to June 2002,there were 96 mitral valve stenosis patients who underwent PBMV in our hospital. Echocardiographic,12 leads united electrocardiogram and other clinical datas were collected at preoperation,1 week after operation,and 4-6 years after operation to retrospectiveanalysis. Multiple stepwise regression analysis was used to assess controllable factors of left atrial remodeling. ResultsLeft atrial diameter reduced from (44.6±6.6)cm before PBMV to (42.8±6.5)cm (P>0.05) 1 week after PBMV and enlarged to (47.2±5.7)cm (all P<0.05) at the end of 4-6 years follow up post operation. The mitral valve area (MVA) increased from (1.06±0.32) cm2 before PBMV to (2.02±0.43) cm2 1 week after PBMV and (1.98±0.36)cm2 4-6 years post operation (all P<0.05). Heart function assessed by NYHA classification improved significantly at 1 week and 4-6 years after surgery compared with pre-operation(P<0.01). Multiple stepwise regression analysis showed that systolic blood pressure at 4-6 years after operation, MVA at 1 week after operation, preoperative atrial fibrillation, Wilkins score≤8, preoperative left atrial diameter were the independent predictive factors of left atrial remodeling at 4-6 years after PBMV.Conclusions PBMV was an effective therapy option for patients with mitral valve stenosis.Systolic blood pressure at 4-6 years after operation, MVA at 1 week after operation, preoperative atrial fibrillation, Wilkins≤8, preoperative left atrial diameter are the predictive factors of left atrial remodeling after PBMV. 相似文献
11.
Objective
Right ventricular (RV) dysfunction in isolated severe mitral stenosis (MS) patients have prognostic significance. Study aim was to assess RV function in these subjects by strain and strain rate analysis, pre and post-balloon mitral valvuloplasty (BMV).Methods
Twenty five patients with isolated severe MS in sinus rhythm were assessed for RV function by two dimensional (2D) longitudinal strain & strain rate imaging before and after BMV and compared with that from twelve healthy age matched controls.Results
Patients with severe MS had significantly lower global RV systolic strain; segmental strain at basal, mid, apical septum and basal RV free wall; but similar strain at mid and apical RV free wall as compared to controls. The systolic strain rate was significantly lower only at mid septum. In addition, they had higher estimated pulmonary artery systolic pressure and RV myocardial performance index; lower tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity at lateral tricuspid annulus, isovolumic acceleration and fractional area change (FAC). Global RV systolic strain as well as, segmental strain at basal, mid and apical septum showed a statistically significant rise after BMV. TAPSE and FAC also increased significantly post BMV.Conclusions
RV systolic function is impaired in patients with severe MS and can be assessed by global and segmental RV strain before the appearance of clinical signs of systemic venous congestion. Impaired global and segmental RV strain values in these patients are primarily due to increased after load and improve after BMV with reduction in RV afterload. 相似文献12.
对51例成功实现经皮二尖瓣球囊扩张成形术(PBMV)的患者,于术前、术后分别测定血栓素(TXB2)及6-酮前列环素F1a(6-K-PGF1a),并与30例正常人作对照。测得数值与二尖瓣口面积(MVA)、左房内径(LAD),二尖瓣跨瓣压差(MVPG)、心脏指数(CI)、平均左房压(MLAP)及右室收缩压(RVSP)进行相关分析。结果表明PBMV前TXB2高于对照组,6-K-PGF1a低于对照组(P＜0.05);PBMV后TXB2较术前降低,6-K-PGF1。增高(P＜0.01);TXB2与MVA呈负相关(r=-0.48,P＜0.05)。提示PBMV后TXB2、6-K-PGF1a水平的变化与MVA大小、MLAP高低密切相关。 相似文献
13.
为探讨经皮二尖瓣球囊成形术 ( PBMV)中选择球囊直径的良好参考指标 ,提高其疗效 ,将 10 0例适宜行 PBMV的二尖瓣狭窄患者随机分为两组 ,一组根据身高、体重和二尖瓣环内径三项指标选择球囊直径行PBMV(综合组 ) ,另一组单纯根据身高选择球囊直径 (身高组 )。结果术后综合组二尖瓣口面积大于身高组 ( P<0 .0 1) ,左房平均压、跨瓣压差均低于身高组 ,最终球囊直径大于身高组 ,二尖瓣返流程度两组无差异。术后 3个月随访仍显示综合组二尖瓣口面积大于身高组 ,二尖瓣反流程度无差异。表明根据身高、体重和二尖瓣环内径选择球囊直径行 PBMV能获得更大的二尖瓣口面积 ,且不增加二尖瓣返流程度。 相似文献
14.
B. Demirkan M.D. Y. Guray U. Guray M.R. Ege H.L. Kisacik H. Sasmaz S. Korkmaz 《Herz》2013,38(2):210-215
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 cm2) 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?<?0.01), PWD (58?±?18 vs 23?±?4, p?<?0.01), the interatrial (55?±?16 vs 36?±?11 ms, p?<?0.01) and left-sided intra-atrial EMD (40?±?11 vs 24?±?12 ms, p?<?0.01) were higher in patients with MS than in healthy subjects. The left atrial (LA) diameter, LA volume and LA volume index had positive association with the interatrial (r?=?0.5, p?<?0.01; r?=?0.5, p?<?0.01 and r?=?0.5, p?<?0.01, respectively) and left-sided intra-atrial EMD (r?=?0.5, p?<?0.01; r?=?0.4, p?<?0.01; r?=?0.4, p?<?0.01 respectively). After PMBV, the interatrial (55?±?16 vs. 40?±?11 ms, p?<?0.01) and left-sided intra-atrial EMD (40?±?11 vs 31?±?10, p?<?0.01) showed significant improvement compared to previous values. There was also a statistically significant difference in maximum P-wave duration and PWD between pre-and post-PMBV (138?±?15 vs 130?±?14, p?<?0.01, and 58?±?18 vs 49?±?16, p?<?0.01, respectively).Conclusions
Our study shows that PMBV has a favorable effect on the electrocardiographic and echocardiographic parameters related with AF risk in patients with MS. 相似文献15.
再次PBMV35例疗效观察 总被引：2，自引：0，他引：2
目的 观察再次经皮二尖瓣球囊成形术 (PBMV)后患者疗效。方法 对 35例 PBMV后再狭窄的患者施行再次 PBMV,并与同期首次接受 PBMV的 36例患者进行疗效比较。结果 两组 PBMV均获成功 ,术后二尖瓣口面积 (MVA)增加 (P<0 .0 1) ,左房平均压 (L AMP)下降 (P<0 .0 1) ,肺动脉平均压 (PAMP)、左房舒张末内径 (L AD)明显降低 (P<0 .0 5 )。再次 PBMV组 MVA增加值及 PAMP下降值均小于首次 PBMV组 (P<0 .0 5 ) ,但 L AMP、L AP无统计学差异。两组均无严重并发症发生。结论 再次 PBMV是 PBMV术后再狭窄患者安全有效的治疗手段 相似文献
16.
Sulafa K.M. Ali Riyadh Abu-Sulaiman Rihab Beshir Agouba 《Journal of the Saudi Heart Association》2015,27(2):71-78
Noncompaction cardiomyopathy (NCCM) is a primary, genetic cardiomyopathy with variable clinical manifestations that include mitral regurgitation (MR).
Methods
This study comprised patients diagnosed with NCCM and MR in two cardiac centers (King Abdul-Aziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia and Sudan Heart Institute, Khartoum, Sudan), and seen in the period between 2002 and 2013. The study describes follow up, clinical, echocardiographic, and histopathological findings.Results
Nineteen cases (85% females) were identified. Ten percent of the cases had relapses and remissions of heart failure. Echocardiographic features included leaflet retraction in all patients, characteristic malcoaptation, and a zigzag deformity of anterior leaflet in 57% of patients. Ruptured chordae were found in 15% of the patients. One patient had pathological examination of the mitral valve which showed myxomatous degeneration, and sclerotic and calcific changes.Conclusion
We describe and discuss a new mechanism for MR caused by NCCM with identifiable clinical and echocardiographic features, and pathological correlations. 相似文献17.
经皮球囊二尖瓣成形术的远期疗效 总被引：1，自引：0，他引：1
目的 观察经皮球囊三尖瓣成形术近期及远期疗效.方法 自1992年4月至2008年11月采用Inoue单球囊法对1768例风湿性心脏病二尖瓣狭窄患者行经皮球囊二尖瓣成形术(PBMV)治疗.对其中自1992年4月至1998年8月426例术后10年患者进行随访.球囊扩张前后均采用同步记录左心房和左心室压力,计算二尖瓣跨瓣压差.术前、术后及随访中均采用超声心动图检查和临床心功能评价.结果 1748例完成PBMV治疗,成功率为98.86%.左心房平均压由术前(38±7)mm Hg(1 mm Hg=0.133 kPa)下降至(12±4)mm Hg(P<0.001),二尖瓣平均跨瓣压差由术前(28±6)mm Hg下降至(8±3)mm Hg(P<0.001),二尖瓣口面积由术前(0.98±0.26)cm~2增加至(1.97±0.39)cm~2(P<0.001).主要并发症为死亡2例,急性心包填塞1例,肺水肿1例,重度二尖瓣反流12例,脑栓塞2例.426例PBMV术后10年随访,心功能仍然维持在纽约心功能Ⅰ～Ⅱ级而未冉进行PBMV或换瓣术者288例(67.6%),冉狭窄140例(33.3%),死亡31例(7.5%).结论 PBMV是治疗风湿性心脏病二尖瓣狭窄的有效方法 . 相似文献
18.
Marian Urban Jan Pirk Ondrej Szarszoi Ivo Skalsky Jiri Maly Ivan Netuka 《Experimental & Clinical Cardiology》2013,18(1):22-26
BACKGROUND:
Double valve replacement for concomitant aortic and mitral valve disease is associated with substantial morbidity and mortality. Excellent results with valve repair in isolated mitral valve lesions have been reported; therefore, whether its potential benefits would translate into better outcomes in patients with combined mitral-aortic disease was investigated.METHODS:
A retrospective observational study was performed involving 341 patients who underwent aortic valve replacement with either mitral valve repair (n=42) or double valve replacement (n=299). Data were analyzed for early mortality, late valve-related complications and survival.RESULTS:
The early mortality rate was 11.9% for valve repair and 11.0% for replacement (P=0.797). Survival (± SD) was 67±11% in mitral valve repair with aortic valve replacement and 81±3% in double valve replacement at five years of follow-up (P=0.187). The percentage of patients who did not experience major adverse valve-related events at five years of follow-up was 83±9% in those who underwent mitral valve repair with aortic valve replacement and 89±2% in patients who underwent double valve replacement (P=0.412). Age >70 years (HR 2.4 [95% CI 1.1 to 4.9]; P=0.023) and renal dysfunction (HR 1.9 [95% CI 1.2 to 3.7]; P=0.01) were independent predictors of decreased survival.CONCLUSIONS:
In patients with double valve disease, both mitral valve repair and replacement provided comparable early outcomes. There were no significant differences in valve-related reoperations, anticoagulation-related complications or prosthetic valve endocarditis. Patient-related factors appear to be the major determinant of late survival, irrespective of the type of operation. 相似文献19.
Maha A. Mohammed Shaimaa A.K. Rady Moustafa O. El-Mokadem Samia M.H. Fadda 《The Egyptian Rheumatologist》2018,40(3):173-178
Aim of the work
To assess the echocardiographic changes using Trans Thoracic Echocardiograghy in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) and to study the relation of the changes to the disease activity and damage.Patients and methods
This study was conducted on 50 SLE patients (25 with and 25 without APS) and 50 controls. The SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborating Clinics Damage index (SLICC/DI) were assessed. Laboratory investigations were performed and transthoracic echocardiography (TTE) was done.Results
The mean age of the patients was 27.7?±?8.5?years and disease duration 4.1?±?3.7?years; 44 females and 6 males; 7.3:1. There was a high frequency of mitral (64%), aortic (22%) and tricuspid (24%) valve regurges as well as pericardial effusion (22%). Left ventricular hypertrophy and atrial dilation was present in 10% of the patients. The frequency of mitral, aortic and tricuspid regurge in SLE patients with APS tended to be higher (84%, 32% and 36%) than in those without (44%, 12% and 12%, respectively). There was a significant correlation between SLEDAI and pericardial effusion (p?=?0.001), between the SLICC/DI with the left ventricular diastolic dysfunction (LVDD) (p?=?0.001), the presence of lupus nephritis with the ejection fraction (p?=?0.02) and between hypertension with the LVDD (p?=?0.001).Conclusion
All SLE patients especially those with APS should be screened for the presence of structural cardiac abnormalities. TTE can be helpful as a noninvasive diagnostic tool for early detection of the abnormalities, resulting in earlier treatment and reduction in mortality and morbidity. 相似文献20.
