Pulmonary hypertension and elevated transpulmonary gradient in patients with mitral stenosis.

Background And Aim Of The Study: Pulmonary hypertension frequently complicates mitral stenosis, with a subset of these patients exhibiting pressures well in excess of their mitral valve hemodynamics. The prevalence of this condition and its impact on clinical outcome following percutaneous balloon mitral commissurotomy (PBMC) is unknown.

Methods: The transpulmonary gradient (TPG) was measured in 317 patients undergoing PBMC; patients were subsequently defined as having either an appropriate or excessive TPG (< or =15 mmHg or >15 mmHg, respectively).

Peripheral blood levels of matrix metalloproteinases in patients referred for percutaneous balloon mitral valve commissurotomy.

Background And Aim Of The Study: Inflammation may play a central role in the progression of stenotic valvular heart disease. Serum levels of matrix metalloproteinases (MMPs), markers of extracellular matrix (ECM) turnover and potential markers of active inflammation, have been recently demonstrated in several inflammatory processes. The present study was designed to examine whether systemic evidence of ECM turnover was present in advanced stenotic mitral valve disease.

Usefulness of percutaneous balloon mitral commissurotomy in preventing the development of atrial fibrillation in patients with mitral stenosis.

A prospective cohort of patients with mitral stenosis and no history of atrial arrhythmias showed no decrease in the incidence of atrial fibrillation (AF) after successful versus unsuccessful Inoue balloon percutaneous balloon mitral valve commissurotomy. Advanced age and left atrial dimension best predicted which patients developed AF during follow-up, whereas percutaneous balloon mitral valve commissurotomy procedural success and left atrial pressure reduction did not have an impact on incidence of AF.

C-reactive protein elevation independently influences the procedural success of percutaneous balloon mitral valve commissurotomy.

Background: Markers of systemic inflammation including C-reactive protein (CRP) appear to predict morbidity and mortality in various clinical conditions. The presence of systemic inflammation and its impact on the procedural success of percutaneous balloon mitral valve commissurotomy (PBMC) in patients with rheumatic mitral stenosis has not been previously demonstrated.

Methods: Measurements of CRP with a high-sensitivity assay were performed at the time of PBMC or during post-procedural follow-up in 119 patients with mitral stenosis of rheumatic morphology.