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Int J Angiol 2023; 32(01): 043-047
DOI: 10.1055/s-0042-1751231
Original Article

Clinical and Hemodynamic Factors Associated with Low Gradient Severe Rheumatic Mitral Stenosis

Amiliana M. Soesanto 
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
,
Dina Roeswita
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
,
Indriwanto S. Atmosudigdo
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
,
Suko Adiarto
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
,
Elen Sahara
1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
› Author Affiliations Funding This research received no grant from any institution or funding agency.
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Abstract

Discrepancy between narrowed mitral valve area and transmitral gradient is not uncommon, suggesting the presence of low gradient (LG)-severe mitral stenosis (MS). Some clinical and hemodynamic factors are believed to associate with LG-severe MS. Transthoracic echocardiography reports were reviewed retrospectively to evaluate the association of all clinical and hemodynamic parameters with LG-severe MS. A 36% of total 322 patients was in the LG-severe MS group. In multivariate analysis, atrial fibrillation (95% confidence interval [CI] 4.60–16.71, odds ratio [OR] 8.77), net atrioventricular compliance > 4 mL/mm Hg (95% CI 3.96–14.25, OR 7.51), tricuspid regurgitation maximal velocity (TR Vmax) > 3.4 m/s (95% CI 0.13–0.48, OR 0.25), stroke volume index ≤ 35 mL/m2 (95% CI 1.49–6.25, OR 3.05), female gender (95% CI 1.30–5.33, OR 2.63), and severe tricuspid regurgitation (95% CI 1.04–5.50, OR 2.39) were found to be associated with LG-severe MS. Atrial fibrillation, net atrioventricular compliance, TR Vmax, stroke volume index, female gender, and severe TR were associated with low transmitral gradient in patients with severe MS.

Keywords

mitral stenosis - low transmitral gradient - echocardiography - rheumatic heart disease

Statement of Ethics

This study was a retrospective study by reviewing hospital medical records. It was approved by the Committee on Institutional Review Board/Health Research Ethics of NCCHK.




Publication History

Article published online:
19 July 2022

© 2022. International College of Angiology. This article is published by Thieme.

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