Abstract
Objective: The aim of the study was to investigate the impact of P-maximum and P-wave dispersion on the long term clinical outcome after successful percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral stenosis (MS) and sinus rhythm. Also to test the correlation between P-variables and right ventricular function and pulmonary artery pressure before and after PMBV. Methods: Eighty-five patients undergoing PMBV were enrolled in this study. We evaluated P-maximum, P-minimum and P-wave dispersion before and one month after PBMV. We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in predicttion of late cardiac events. Results: There were significant decreases in mean diastolic gradient, PAP, and LA size and significant improvement in right ventricular tissue Doppler indices after PMBV. Ac- company these hemodynamic changes after PMBV. P-maximum and P-wave dispersion were found to be decreased (P off values of ≥62.8 msec for P-wave dispersion and 118 mes for P-maximum.ROC curve showed AUC of 0.919 for P-wave dispersion and 0.913 for P-maximum (P
Highlights
P-wave prolongation has been used as a marker of interatrial conduction disturbance and prolonged atrial conduction time, which has been associated with a high frequency of atrial fibrillation (AF)
We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in prediction of late cardiac events
P-maximum and P-wave dispersion could be considered as independent predictors of late outcome of patients with mitral stenosis (MS) after successful PMBV (AF, recurrent hospital admission, embolic phenomenon deterioration of right ventricular function)
Summary
P-wave prolongation has been used as a marker of interatrial conduction disturbance and prolonged atrial conduction time, which has been associated with a high frequency of atrial fibrillation (AF). These atrial conduction disturbances are nonuniform and site dependent, and may result in a highly variable P-wave duration in the different leads of a 12-lead electrocardiogram (ECG). There are numerous predictors of late events following the procedure—age, functional class IV, previous surgical commissurotomy, moderate to severe mitral OPEN ACCESS. Even there are no studies about the impact of P-wave duration and P-wave dispersion in prediction of late events after percutaneous balloon mitral valvuloplasty
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