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Two-dimensional and Doppler echocardiographic determinants of the natural history of mitral valve narrowing in patients with rheumatic mitral stenosis: implications for follow-up.

Publication ,  Journal Article
Gordon, SP; Douglas, PS; Come, PC; Manning, WJ
Published in: J Am Coll Cardiol
April 1992

Fifty patients with rheumatic mitral stenosis were studied with serial two-dimensional and Doppler echocardiography to determine the natural history of changes in mitral valve area and its relation to transmitral gradients and mitral valve morphology. Over the 39-month observation period (range 7 to 74 months) the decline in valve area was 0.09 +/- 0.21 cm2/year. In addition, there were significant increases in total echocardiographic score (p = 0.0001), severity of mitral anulus calcification (p = 0.05) and severity of mitral regurgitation (p = 0.0007). Patients with an echocardiographic score greater than or equal to 8 had a more progressive course. In addition, patients with a more progressive course (decline in valve area greater than or equal to 0.1 cm2/year) had a significantly greater initial mean gradient (p = 0.01), peak gradient (p = 0.007) and total echocardiographic score (p = 0.0008). Initial valve area did not correlate with the rate of stenosis progression. Of 22 patients with an echocardiographic score less than 8 and a peak mitral gradient less than 10 mm Hg, only 1 patient (5%) had a more progressive course, compared with 80% of those with a total echocardiographic score greater than or equal to 8 and a gradient greater than or equal to 10 mm Hg. The rate of mitral valve narrowing in individual patients with rheumatic mitral stenosis is variable. Patients whose valve disease progresses rapidly are those with a greater mitral valve echocardiographic score and higher peak and mean transmitral gradients.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

April 1992

Volume

19

Issue

5

Start / End Page

968 / 973

Location

United States

Related Subject Headings

  • Rheumatic Heart Disease
  • Prognosis
  • Mitral Valve Stenosis
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Female
  • Echocardiography, Doppler
  • Echocardiography
 

Citation

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Gordon, S. P., Douglas, P. S., Come, P. C., & Manning, W. J. (1992). Two-dimensional and Doppler echocardiographic determinants of the natural history of mitral valve narrowing in patients with rheumatic mitral stenosis: implications for follow-up. J Am Coll Cardiol, 19(5), 968–973. https://doi.org/10.1016/0735-1097(92)90280-z
Gordon, S. P., P. S. Douglas, P. C. Come, and W. J. Manning. “Two-dimensional and Doppler echocardiographic determinants of the natural history of mitral valve narrowing in patients with rheumatic mitral stenosis: implications for follow-up.J Am Coll Cardiol 19, no. 5 (April 1992): 968–73. https://doi.org/10.1016/0735-1097(92)90280-z.
Gordon, S. P., et al. “Two-dimensional and Doppler echocardiographic determinants of the natural history of mitral valve narrowing in patients with rheumatic mitral stenosis: implications for follow-up.J Am Coll Cardiol, vol. 19, no. 5, Apr. 1992, pp. 968–73. Pubmed, doi:10.1016/0735-1097(92)90280-z.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

April 1992

Volume

19

Issue

5

Start / End Page

968 / 973

Location

United States

Related Subject Headings

  • Rheumatic Heart Disease
  • Prognosis
  • Mitral Valve Stenosis
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Female
  • Echocardiography, Doppler
  • Echocardiography