The Study Of Left Atrial Pressure Measurement To Guide The Endpoint Of PBMV Expansion In The Case Of Right Ventricular Pacing

Objective: To investigate the relationship between the changes of left atrial pressure(LAP)and the ideal end points of percutaneous balloon mitral valvuloplasty(PBMV)in patients with right ventricular pacing,and to provide an objective basis for the accurate judgement of the end points of PBMV.Methods: 42 patients with mitral stenosis who will undergo PBMV were randomly divided into two groups: control group and pacing group.In the control group,multiple ways were used to estimate whether the PBMV had reached the end points:balloon diameter calculation,auscultation of heart murmur and balloon shape observation,as well as a dynamical monitoring of LAP.On the other hands,all the patients in the pacing group underwent a right ventricular rapid pacing before PBMV,then the expansion end points was determined in the same way.The general clinical data of patients,the echocardiography indexes and cardiac function index were rocorded,all the statistical data were processed by SPSS13.0 statistical software.By means of group comparison and in group comparison,we analysed the changes of echocardiography and cardiac function index between two groups before and after PBMV.BY investigating the relationship between the changes of LAP and the ideal end points of PBMV in case of right ventricular pacing,we provided more experimental basis to comple the PBMV safely and effectively.Results: After PBMV,LAP decreased rapidly in all patients while MVA increased significantly.One week after PBMV,6MWT increased obviously,the left atrial diameter(LAD)decreased and cardiac function(NYHA)improved.The degree of mitral regurgitation(MR),Wilkins score and 6MWT 1 week after operation between the two groups were significantly different(P < 0.05).Conclusion: PBMV may improve the clinical symptom and hemodynamic immediatly,the exercise tolerance was significantly improved.As the effect of different heart rate and rhythm were excluded,the selection of endpoints was more scientific and accurate in the monitoring group,the prognosis is much more better.