Table 3.
LF/LG Versus HG MS
| LF/LG MS (n=11) | NF/LG MS (n=44) | HG MS (n=46) | P Value | |
|---|---|---|---|---|
| Demographics | ||||
| Age, y | 73±7‡ | 63±10‡ | 56±13‡ | <0.0001 |
| Women, % | 73 | 98 | 91 | 0.04 |
| BMI, kg/m2 | 28.2±4.9 | 30.2±6.6 | 28.6±5.5 | 0.4 |
| Paroxysmal/permanent AF, % | 91 | 50 | 26 | 0.0002 |
| Hypertension, % | 64 | 43 | 43 | 0.4 |
| Diabetes mellitus, % | 36 | 11 | 11 | 0.4 |
| Stroke, % | 55 | 2 | 4 | <0.0001 |
| Coronary artery disease, % | 18 | 5 | 11 | 0.2 |
| NYHA class (II/III), % | 18/82 | 34/66 | 11/89 | 0.02 |
| Echocardiography | ||||
| Heart rate, bpm | 73±12 | 71±12† | 78±12 | 0.03 |
| LV end‐diastolic diameter, cm | 43±4 | 48±5‡ | 45±5 | 0.001 |
| LV end‐systolic diameter, cm | 30±5 | 30±4 | 28±4 | 0.09 |
| EF, % | 57±10‡ | 65±4 | 63±6 | 0.002 |
| LV mass index, g/m2 | 81±22 | 90±21 | 85±22 | 0.3 |
| Relative wall thickness, cm | 0.47±0.09 | 0.41±0.05 | 0.43±0.09 | 0.06 |
| LA volume index, mL/m2 | 60±13 | 56±17 | 59±17 | 0.6 |
| Abnormal RV function, % | 18 | 7 | 24 | 0.06 |
| Abnormal RV size, % | 27 | 9 | 24 | 0.09 |
| SVI, mL/m2 | 30±3‡ | 50±10‡ | 40±7‡ | <0.0001 |
| Cardiac index, L/min per m2 | 2.3±0.3‡ | 3.2±0.6 | 3.1±0.5 | <0.0001 |
| E wave, m/s | 2.1±0.3 | 1.9±0.3† | 2.4±0.4 | <0.0001 |
| Medial e′, cm/s | 4±2 | 5±1 | 5±2 | 0.6 |
| RV systolic pressure, mm Hg | 46±15 | 45±9 | 63±23‡ | <0.0001 |
| Abascal score | 9±2‡ | 7±1 | 7±2 | 0.02 |
| Subvalvular thickening | 100 | 82 | 44 | 0.03 |
| MG, mm Hg | 8±1 | 7±2 | 14±4‡ | <0.0001 |
| PHT, ms | 195±30 | 172±23 | 190±44 | 0.04 |
| MVA (PHT), cm2 | 1.16±0.17 | 1.30±0.17 | 1.21±0.24 | 0.06 |
| MR, % | ||||
| None/trivial | 27 | 23 | 26 | 0.7 |
| Mild | 36 | 57 | 54 | |
| Mild‐moderate | 37 | 20 | 20 | |
| Catheterization | ||||
| Mean atrial pressure, mm Hg | 110±10 | 106±15 | 103±15 | 0.4 |
| Cardiac index, L/min per m2 | 2.0±0.4‡ | 2.6±0.5 | 2.7±0.6 | 0.003 |
| SVI, mL/m2 | 27±5‡ | 39±8 | 35±7 | 0.0004 |
| LA pressure, mm Hg | 21±4 | 20±6† | 24±7 | 0.001 |
| LVEDP, mm Hg | 15±3 | 16±5 | 13±4 | 0.08 |
| MG, mm Hg | 8±3 | 8±2 | 12±4‡ | <0.0001 |
| MVA, cm2 | 1.2±0.3 | 1.5±0.4† | 1.3±0.4 | 0.002 |
| Mean PAP, mm Hg | 35±7 | 31±9† | 42±12 | <0.0001 |
| PVR, WU | 3.6±1.7 | 2.4±1.3† | 3.7±2.0 | 0.006 |
| Ventricular vascular coupling | ||||
| Ea, mm Hg/mL | 2.1±0.5‡ | 1.3±0.3‡ | 1.5±0.3‡ | <0.0001 |
| Ees, mm Hg/mL | 1.9±0.5 | 2.1±0.7 | 1.9±0.6 | 0.3 |
| Ea/Ees | 1.12±0.22* | 0.63±0.11* | 0.84±0.24* | <0.0001 |
| Stiffness constant β | 0.61±0.13* | 0.48±0.13 | 0.540.14 | 0.007 |
| V30, mL | 93±21 | 121±27‡ | 106±25 | 0.003 |
AF indicates atrial fibrillation; BMI, body mass index; bpm, beats per minute; Ea, effective arterial elastance; Ea/Ees, effective arterial elastance/end‐systolic elastance ventricular vascular coupling; Ees, end‐systolic elastance; EF, ejection fraction; LA, left atrial; LF, low‐flow; LV, left ventricular; LVEDP, left ventricular end‐diastolic pressure; MG, mean gradient; MR, mitral regurgitation; MVA, mitral valve area; NYHA, New York Heart Association; PAP, pulmonary artery pressure; PHT, pressure half‐time; PVR, pulmonary vascular resistance; RV, right ventricular; SVI, stroke volume index; V30, predicted left ventricular end‐diastolic volume at a common left ventricular filling pressure of 30 mm Hg.
*P<0.05 vs normal‐flow (NF), low‐gradient (LG) mitral stenosis (MS), † P<0.05 vs high‐gradient (HG) MS, ‡ P<0.05 vs all.