Cardiovascular Magnetic Resonance in Predicting the Reduction in Pulmonary Artery Pressure in Patients With Mitral Stenosis After Surgical or Interventional Treatment

Authors

1 Cardiovascular Intervention Research Center, Rajaie Cardiovascular , Medical , and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran

2 Rajaie Cardiovascular , Medical , and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran

Abstract

Background: Pulmonary hypertension (PH) is a common consequence of mitral stenosis (MS).
After treatment, PH reverses depending on the chronicity and severity of MS. The
characteristic changes in the pulmonary artery (PA) secondary to an elevated pulmonary
artery pressure (PAP) can be evaluated via cardiovascular magnetic resonance imaging
(CMR). In this study, we aimed to evaluate if there was any correlation between PAP and
hemodynamic findings measured by CMR and whether these findings could be useful in
predicting the PAP response after MS relief.
Methods: Thirty-three patients with a diagnosis of severe MS, who were candidated for
percutaneously transvenous mitral commissurotomy (PTMC) or mitral valve replacement
(MVR), were included. CMR was performed in all of them before the procedure and PA
distensibility, PA peak velocity, PA forward volume, and PA forward flow were measured.
Transthoracic echocardiography was performed at baseline, immediately after the
procedure, and 3 months after MS relief for the assessment systolic PAP.
Results: Thirty-three patients with a diagnosis of MS+PH (15 PTMC and 18 MVR) were enrolled
in this study. The mean PAP at baseline catheterization ranged from 25 to 70 mm Hg. There
was a significant drop in systolic PAP immediately after the procedure and 3 months after
MS relief. There was no relationship between the PA distensibility index and systolic PAP
changes after MS relief. PA peak velocity was significantly higher in the patients with >
50% drops in their systolic PAP 3 months after the treatment. The multivariable analysis
showed that none of the CMR findings was an independent predictor of a more systolic PAP
decline.
Conclusions: Although we found no significant relationship between CMR findings and systolic
PAP changes after MS treatment, the result of this study can be used for further
investigations in this regard.

Keywords

Iranian Heart Journal
Volume 18, Issue 1
March 2017
Pages 30-36

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