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Assessing the severity of mitral stenosis: variability between noninvasive and invasive measurements in patients with symptomatic mitral valve stenosis.

Publication ,  Journal Article
Wang, A; Ryan, T; Kisslo, KB; Bashore, TM; Harrison, JK
Published in: Am Heart J
October 1999

BACKGROUND: This study evaluated the correlation and variability between noninvasive and invasive measures of mitral stenosis severity before and after balloon mitral commissurotomy (BMC) in a large group of patients with symptomatic mitral stenosis. Factors related to variability between measurements were determined. METHODS: The Doppler transmitral gradient, Doppler half-time valve area, and 2-dimensional echocardiographic (2D) mitral valve area (MVA) were measured immediately before and 1 day after BMC in 272 consecutive patients with mitral stenosis and compared with their respective measures during cardiac catheterization. RESULTS: The correlation coefficient for the comparison of noninvasive and invasive measurements of the transmitral gradient was 0.63 before BMC and 0.60 after the procedure; for 2D versus Gorlin-derived MVA, 0.39 and 0.57, respectively; and for Doppler half-time versus Gorlin-derived MVA, 0.31 and 0.18, respectively. A large degree of variability in the measurement of MVA was present among the 3 techniques before BMC and increased after BMC. Before BMC, for the comparison of 2D and Gorlin-derived MVA, variables predictive of the discrepancy were age, echocardiographic score, transmitral gradient during catheterization, and cardiac index. For the comparison of Doppler half-time versus Gorlin-derived MVA, age, heart rate during cardiac catheterization and echocardiography, cardiac output and left ventricular end-diastolic pressure predicted the difference between the 2 measures. CONCLUSIONS: In symptomatic patients with mitral stenosis, there is significant variability between noninvasive and invasive measures of mitral stenosis severity despite careful, reproducible measurements. The difference between noninvasive and invasive measures of MVA before BMC is strongly related to cardiac output.

Duke Scholars

Published In

Am Heart J

DOI

ISSN

0002-8703

Publication Date

October 1999

Volume

138

Issue

4 Pt 1

Start / End Page

777 / 784

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Mitral Valve Stenosis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography, Doppler
  • Echocardiography
  • Catheterization
  • Cardiovascular System & Hematology
 

Citation

APA
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ICMJE
MLA
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Wang, A., Ryan, T., Kisslo, K. B., Bashore, T. M., & Harrison, J. K. (1999). Assessing the severity of mitral stenosis: variability between noninvasive and invasive measurements in patients with symptomatic mitral valve stenosis. Am Heart J, 138(4 Pt 1), 777–784. https://doi.org/10.1016/s0002-8703(99)70196-1
Wang, A., T. Ryan, K. B. Kisslo, T. M. Bashore, and J. K. Harrison. “Assessing the severity of mitral stenosis: variability between noninvasive and invasive measurements in patients with symptomatic mitral valve stenosis.Am Heart J 138, no. 4 Pt 1 (October 1999): 777–84. https://doi.org/10.1016/s0002-8703(99)70196-1.
Wang, A., et al. “Assessing the severity of mitral stenosis: variability between noninvasive and invasive measurements in patients with symptomatic mitral valve stenosis.Am Heart J, vol. 138, no. 4 Pt 1, Oct. 1999, pp. 777–84. Pubmed, doi:10.1016/s0002-8703(99)70196-1.
Journal cover image

Published In

Am Heart J

DOI

ISSN

0002-8703

Publication Date

October 1999

Volume

138

Issue

4 Pt 1

Start / End Page

777 / 784

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Mitral Valve Stenosis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography, Doppler
  • Echocardiography
  • Catheterization
  • Cardiovascular System & Hematology