Abstract:
OBJECTIVES:To explain the discrepancy between the symptomatic status of patients and the hemodynamically calculated mitral valve area during long-term follow-up after mitral balloon valvulotomy, mitral valve orifice variability after dobutamine infusion was investigated in two groups of patients. BACKGROUND:A significant increase in aortic valve area with increased aortic transvalvular flow has been reported in patients with calcific aortic stenosis after aortic balloon valvulotomy. A similar phenomenon with regard to the mitral valve has not been studied in detail. METHODS:Group 1 comprised 10 patients (mean age 33 +/- 9 years) with untreated mitral stenosis. Group 2 comprised 29 consecutive patients (mean age 32 +/- 7 years) who underwent successful percutaneous mitral balloon valvulotomy 13 +/- 2 months before the study. RESULTS:After dobutamine infusion, heart rate and cardiac index increased significantly in both groups. The mean pulmonary artery pressure, mitral valve gradient and pulmonary capillary pressure remained unchanged in Group 2 but increased significantly in Group 1. The mean mitral valve area was significantly larger in Group 2 after dobutamine infusion than at baseline (1.9 +/- 0.5 vs. 2.4 +/- 0.6 cm2, p < 0.0001) but was unchanged in Group 1 (1.2 +/- 0.2 vs. 1.3 +/- 0.3 cm2, p = NS). The mean mitral valve area in seven patients in Group 2 (24%) was < or = 1.5 cm2 before dobutamine infusion (1.3 +/- 0.4 cm2), which was defined as restenosis. In five of these seven patients who had minimal or no symptoms, the mitral valve area increased significantly after dobutamine infusion (1.3 +/- 0.1 vs. 1.9 +/- 0.1 cm2). In the other two patients who were symptomatic, the mitral valve area did not change after dobutamine infusion. These two patients were identified as having "true" restenosis, and redilation of the mitral valve was performed in both. CONCLUSIONS:In patients who underwent mitral balloon valvulotomy, increased mitral valve reserve capacity contributed to symptomatic improvement on long-term follow-up. Dobutamine infusion may be helpful in detecting clinically significant restenosis.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Okay T,Deligönül U,Sancaktar O,Kozan Odoi
10.1016/0735-1097(93)90597-tsubject
Has Abstractpub_date
1993-11-15 00:00:00pages
1691-6issue
6eissn
0735-1097issn
1558-3597pii
0735-1097(93)90597-Tjournal_volume
22pub_type
杂志文章abstract:BACKGROUND:Rates of referral to cardiac rehabilitation after percutaneous coronary intervention (PCI) have been historically low despite the evidence that rehabilitation is associated with lower mortality in PCI patients. OBJECTIVES:This study sought to determine the prevalence of and factors associated with referral ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jacc.2015.02.063
更新日期:2015-05-19 00:00:00
abstract::Coronary heart disease (CHD) remains the leading cause of death among American women. Numerous differences exist between younger and older women and between women and men with respect to the pathology of CHD and its incidence and prevalence over the life cycle. Differences in lipoprotein levels and lipid fractions pla...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2005.05.089
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:We sought to study the anatomy of human ligament of Marshall (LOM). BACKGROUND:Although the LOM has been implicated in the genesis of focal atrial tachyarrhythmias, its gross anatomic and microscopic features in humans hearts have not been completely defined. METHODS:We studied seven postmortem human heart...
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doi:10.1016/s0735-1097(00)00819-6
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abstract:OBJECTIVES:We sought to evaluate the prognostic impact of right ventricular (RV) myocardial involvement in patients with inferior myocardial infarction (MI). BACKGROUND:There is uncertainty regarding the risk of major complications in patients with inferior MI complicated by RV myocardial involvement. Whether these co...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,meta分析,多中心研究,随机对照试验
doi:10.1016/s0735-1097(00)01089-5
更新日期:2001-01-01 00:00:00
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doi:10.1016/j.jacc.2003.06.004
更新日期:2003-11-05 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2015.09.068
更新日期:2015-12-08 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80261-x
更新日期:1992-03-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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更新日期:1995-11-01 00:00:00
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更新日期:2020-07-07 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)90612-2
更新日期:1994-04-01 00:00:00
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doi:10.1016/j.jacc.2006.11.042
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pub_type: 杂志文章
doi:10.1016/s0735-1097(02)01990-3
更新日期:2002-08-07 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-04-08 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1016/0735-1097(88)92597-1
更新日期:1988-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jacc.2006.10.071
更新日期:2007-03-20 00:00:00
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更新日期:1996-03-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1990-07-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-07-01 00:00:00
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更新日期:2020-08-04 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1987-03-01 00:00:00
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更新日期:1990-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2003-02-19 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2020-03-24 00:00:00
abstract::Myocardial reperfusion after reversible regional ischemia is known to result in delayed recovery of contractile function, but the mechanism responsible for this phenomenon remains unclear. We examined the ability of N-2-mercaptopropionylglycine, a synthetic thiol compound with oxygen free radical scavenging properties...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1986-11-01 00:00:00