| Objective: (1) To study the conditions of left ventricular mass (LVM) andcardiac systolic function in patients with rheumatic mitral stenosis by transthoracicechocardiography. (2) To detect the changes of left ventricular mass and leftventricular systolic function (LVSF) in patients with rheumatic mitral stenosis afterpercutaneous balloon mitral valvuloplasty (PBMV). (3) To explore the relationsbetween mitral valve area and left ventricular mass, left ventricular systolicfunction 3 days after operation, and to assess the correlation between leftventricular mass and left ventricular systolic function 3 months after operation. (4)To evaluate the influence of percutaneous balloon mitral valvuloplasty on leftventricular mass and left ventricular systolic function in patients with rheumaticmitral stenosis, and then to provide clinical evidences for judging the curativeeffect after PBMV.Materials and Methods: From June 2004 to December 2004, the studypopulation consisted of 60 cases at First Affiliated Hospital of Guangxi MedicalUniversity, falling into two groups: (1) rheumatic mitral stenosis group: 40 patients( 10 male and 30 female, mean age 41.58±11.21 years, range 21 to 62 years ) hadtwo-dimensional echocardiography evidence of mitral stenosis; (2) the controlgroup: 20 healthy volunteers (7 male and 13 female, mean age 41.80±10.24 years,range 23 to 62 years) whose physical examinations was normal. Forty patientswith mitral stenosis were examined on the variation of LVM, LVSF, and thediameter of left ventricle end-diastole (LVD) by echocardiography using PhilipsSonos 5500 and 7500 echocardiography imaging system (Agilent Company, USA)before and after PBMV, and compared with age-matched 20 healthy volunteersbefore PBMV. Forty patients were studied using echocardiography 3 days beforeand 3 days, 3 months after PBMV respectively. Transthoracic M-mode,two-dimensional and Doppler echocardiography were performed in all studyobjects. Left ventricular mass was calculated by two-dimensionalechocardiography according to area-length method recommended by AmericanSociety of Echocardiography (ASE). Left ventricular mass index (LVMI) wasobtained from left ventricular mass being indexed to body surface area. M-modeechocardiography was performed to measure LVD and to calculate left ventricularsystolic function (EF), fraction shortening (FS), stroke volume (SV), and cardiacoutput (CO) according to the Teichholz emendation formula recommended by ASE.Mitral valve area was calculated by two-dimensional and Dopplerechocardiography according to ellipse area formula and pressure half time(PHT)method respectively.All numeric data were displayed as mean±standard deviation (x±s). SPSS10.0 statistical software package for Windows was used to analyze all data. Data ofmitral stenosis group before and after PBMV were compared by Paired-Samples TTest. Data of normal control subjects and mitral stenosis group before PBMV werecompared by Independent-Samples T Test. Linear correlative analysis was used toanalyze the correlation between MVA and EF, FS, LVM,LVMI 3 days after PBMVand the correlation between LVM,LVMI and EF, FS 3 months after PBMV. A Pvalue of less than 0.05 was considered statistic significancy.Results: (1) LVD, interventricular septal thickness (IVST), left ventricularposterior wall thickness(LVPWT), LVM, left ventricular mass index (LVMI) andLVSF in patients with MS were significantly smaller than those in normal controlsubjects (P<0.01). (2) LVD, ejection fraction (EF), stroke volume (SV), cardiacoutput (CO), and fraction shortening (FS) were significantly increased in allpatients 3 day after PBMV (P <0.01). There were some enhances in IVST, LVPWT,LVM, and LVMI (P<0.05). (3) IVST, LVPWT, LVM, and LVMI had furtherimprovement 3 months after PBMV (P<0.01), and there were similar furtherenhances in EF and FS (P<0.01). (4) Linear correlative analysis showed that LVM,LVMI, EF, and FS improved as mitral valve area (MVA) increased 3 days afterPBMV. These increases in LVM, LVMI, EF, and FS were directly correlated withmitral valve open...
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