[Clinico-morphological dissociation in patients with mitral valve stenosis].

Purpose: To study characteristics of the natural history of mitral stenosis (MS) in patients that have no correlation between mitral valve areas (MVA) and symptoms.

Methods: We studied 18 patients with MS, that presented no correlation between MVA and functional class (FC), 16 (89%) were female and two (11%) men, with age ranging from 16 to 54 (mean 33) years. Patients assigned to group A (8 cases) had FC III and MVA > or = 1.5 cm2 and group B (10 cases) FC I/II and MVA < 1.1 cm2. FC and MVA at the start (initial time-It) and after 12 months or before surgical correction (SC) or percutaneous mitral balloon valvuloplasty (PBV) (final time-Ft) were compared. All patients with predict O2 uptake (%PRED VO2) at It were evaluated.

Results: Five (63%) patients of group A, that maintained MVA > or = 1.5 cm2, changed to FC I/II but three (38%) needed a SC or PBV (2 with lesser MVA at Ft). At group B, six (60%) patients needed SC or PBV.

Conclusion: MS patients with MVA > or = 1.5 and FC III, providing MVA do not decrease, improves their FC, becoming it more compatible with MVA %PRED VO2. The cases of group B presented the greatest probability of needing SC or PVB.