Changes Of Plasma CGRP And Angâ…¡ Concentration Before And After Percutaneous Balloon Mitral Valvuloplasty In Patients With Mitral Stenosis

Objective To determine the plasma levels of calcitonin gene-related peptide(CGRP)and angiotensinⅡ(AngⅡ) in patients with mitral stenosis before and after percutaneous balloon mitral valvuloplasty(PBMV),explore the relation between these changes and haemodynamic variables before and after PBMV.Methods The plasma levels of CGRP and AngⅡ in vein and in left atrial were measured in 38 patients with mitral stenosis before and immediately after PBMV respectively, and then the vein plasma levels of CGRP and AngⅡ were measured 3 days after PBMV. Similarly, left atrial diameter(LAD),mitral valve area(MVA),mitral pressure of gradient(MPG),systolic pulmonary arteral pressure(SPAP),left ventricular ejection fraction(LVEF) were measured in patients with echocardiography before and 3 days after PBMV. Mean left atrial pressure(MLAP) were measured with heart catheter before and immediately after PBMV. In contrast to patients, the vein plasma levels of CGRP and AngⅡ were determined in 30 healthy persons.Result Before PBMV, the vein plasma level of CGRP in patients with mitral stenosis is lower than that in healthy persons(38.23± 8.82μg/L vs 57.71±11.35μg/L P<0.001), while the vein plasma level of AngⅡ is higher than that in healthy person (186.53±39.48pg/ml vs 87.86±30.03pg/ml P <0.001). Left atrial plasma level and vein plasma level of CGRP and AngⅡ are no difference before and immediately after PBMV. Left atrial plasma level of CGRP in patients is decrease from 41.82 ± 10.73μg/L to 30.61士 8.07μg/L immediately after PBMV. The vein plasma level of CGRP is increased from 38.23±8.82μg/L to 49.2±11.67μg/L 3 days after PBMV, while the vein plasma levels of AngⅡ is decreased from 186.5±39.48pg/ml to 95.63±28.72pg/ml 3 days after PBMV.The vein plasma of CGRP is negative correlated with MLAP, SPAP(r= -0.68,r= -0.52). The vein plasma level of AngⅡ is positive correlated with left atrial pressure.(r= 0.472)Conclusion The vein plasma concentration of CGRP increased and that of AngⅡ decreased in patients with mitral stenosis after PBMV. We had to do more jobs to explore the reason between these changes in PBMV.