P wave dispersion as a valuable marker in prediction of outcome of tricuspid regurgitation and improved right ventricular function after percutaneous balloon mitarl valvuloplasty in patients with mitral stenosis

Abstract

To investigate the impact of P-wave dispersion (PWD) outcome of tricuspid regurgitation (TR) and right ventricular (RV) function after successful percutaneous mitral balloon valvuloplasty (PMBV) in patients with mitral stenosis (MS) and sinus rhythm. Seventy-eight consecutive patients undergoing PMBV were enrolled in this study. We evaluated PWD before and 1 month after PBMV. We studied the TR severity and RV function, in addition to the changes in pulmonary artery pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, the changes before and after PMBV. Patients with TR regression and improved RV function were classified as group A and those without regression of TR were classified as group B. There were significant decreases in mean diastolic gradient, PAP, and LA size, significant regression of TR from moderate-severe TR to mild TR and improvement in RV function after PMBV. PWD significantly decreased (P < 0.001). Group B patients during follow-up had a higher PWD than those in group A (P < 0.001). It was revealed with linear regression and correlation analysis that the degree of changes in PWD were correlated with development of regression of TR and improved RV funcion after PMBV. P-wave maximum and dispersion are significantly increased in patients with MS. They decreased significantly after PMBV. They were significantly correlated with TR severity and impairment of right ventricular function and the degree of PAP. P maximum and dispersion could be considered as independent predictors of TR regression and improved RV functionin patients with MS after PMBV.