Role of exercise echocardiography in decision making of balloon valvuloplasty in moderate mitral valve stenosis

ABSTRACT

Assessment of value of exercise echocardiography using in patients with rheumatic moderate mitral valve stenosis in interventional decision making [percutenous balloon mitral valvuloplasty]. 30 patients with moderate mitral stenosis were participated in the study. All patients were subjected to exercise echocardiography and were divided into two groups. Group I 20 patients with good exercise tolerance and group II 10 patients with poor exercise tolerance and mitral valvuloplasty was done, and then reevaluated with exercise echocardiography one month after valvuloplasty. In group [I] mean pressure gradient across mitral valve at peak of exercise was ranged between 12 and 16 mmHg with mean of 134.78 +/- 1.33 mmHg, while in group[II] mean pressure gradient across mitral valve at peak of exercise was ranged between 17 and 20 mmHg with mean of 18.30 +/- 1.25 mmHg. In group [I] pulmonary artery pressure at peak of exercise ranged between 25 and 40 mmHg with mean of 30.00 +/- 5.38 mmHg, while in group [II] it was ranged between 35 and 40 mmHg with mean of 39.00 +/- mmHg at peak of exercise. All members of group II had subvalvular affection [high score] and 50% of them had high score for calcification with poor exercise tolerance while non of group I had subvalvular affection and only 10% of them had law calcific score]. Exercise echocardiography plays an important role in evaluating true symptomatic patients and assesses the hemodynamic severity in patients with moderate mitral stenosis