PMID- 24936309
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140617
LR  - 20211021
IS  - 2061-1617 (Print)
IS  - 2061-5094 (Electronic)
IS  - 2061-1617 (Linking)
VI  - 6
IP  - 2
DP  - 2014 Jun
TI  - Pulmonary function derangements in isolated or predominant mitral stenosis - 
      Preoperative evaluation with clinico-hemodynamic correlation.
PG  - 75-84
LID - 10.1556/IMAS.6.2014.2.4 [doi]
AB  - INTRODUCTION: It is well known that mitral stenosis (MS) is complicated by 
      pulmonary hypertension (PH) of varying degrees. The hemodynamic derangement is 
      associated with structural changes in the pulmonary vessels and parenchyma and 
      also functional derangements. This article analyzes the pulmonary function 
      derangements in 25 patients with isolated/predominant mitral stenosis of varying 
      severity. AIMS: THE AIM OF THE STUDY WAS TO CORRELATE THE PULMONARY FUNCTION TEST 
      (PFT) DERANGEMENTS (DONE BY SIMPLE METHODS) WITH: a) patient demographics and 
      clinical profile, b) severity of the mitral stenosis, and c) severity of 
      pulmonary artery hypertension (PAH) and d) to evaluate its significance in 
      preoperative assessment. SUBJECTS AND METHODS: This cross-sectional study was 
      conducted in 25 patients with mitral stenosis who were selected for mitral valve 
      (MV) surgery. The patients were evaluated for clinical class, echocardiographic 
      severity of mitral stenosis and pulmonary hypertension, and with simple methods 
      of assessment of pulmonary function with spirometry and blood gas analysis. The 
      diagnosis and classification were made on standardized criteria. The associations 
      and correlations of parameters, and the difference in groups of severity were 
      analyzed statistically with Statistical Package for Social Sciences (SPSS), using 
      nonparametric measures. RESULTS: THE SPIROMETRIC PARAMETERS SHOWED SIGNIFICANT 
      CORRELATION WITH INCREASING NEW YORK HEART ASSOCIATION (NYHA) FUNCTIONAL CLASS 
      (FC): forced vital capacity (FVC, r = -0.4*, p = 0.04), forced expiratory volume 
      in one second (FEV1, r = -0.5*, p = 0.01), FEV1/FVC (r = -0.44*, p = 0.02), and 
      with pulmonary venous congestion (PVC): FVC (r = -0.41*, p = 0.04) and FEV1 (r = 
      -0.41*, p = 0.04). Cardiothoracic ratio (CTR) correlated only with FEV1 (r = 
      -0.461*, p = 0.02) and peripheral saturation of oxygen (SPO2, r = -0.401*, p = 
      0.04). There was no linear correlation to duration of symptoms, mitral valve 
      orifice area, or pulmonary hypertension, except for MV gradient with PCO2 (r = 
      0.594**, p = 0.002). The decreased oxygenation status correlated significantly 
      with FC, CTR, PVC, and with deranged spirometry (r = 0.495*, p = 0.02). 
      CONCLUSIONS: PFT derangements are seen in all grades of severity of MS and 
      correlate well with the functional class, though no significant linear 
      correlation with grades of severity of stenosis or pulmonary hypertension. Even 
      the early or mild derangements in pulmonary function such as small airway 
      obstruction in the less severe cases of normal or mild PH can be detected by 
      simple and inexpensive methods when the conventional parameters are normal. The 
      supplementary data from baseline arterial blood gas analysis is informative and 
      relevant. This reclassified pulmonary function status might be prognostically 
      predictive.
FAU - Parvathy, Usha T
AU  - Parvathy UT
AD  - MPS Hospital, Department of Cardiac Surgery, Peoples Friendship University of 
      Russia Moscow Russian Federation.
FAU - Rajan, Rajesh
AU  - Rajan R
AD  - MPS Hospital, Department of Cardiac Surgery, Peoples Friendship University of 
      Russia Moscow Russian Federation.
FAU - Faybushevich, Alexander Georgevich
AU  - Faybushevich AG
AD  - MPS Hospital, Department of Cardiac Surgery, Peoples Friendship University of 
      Russia Moscow Russian Federation.
LA  - eng
PT  - Journal Article
DEP - 20140604
PL  - Hungary
TA  - Interv Med Appl Sci
JT  - Interventional medicine & applied science
JID - 101539233
PMC - PMC4047508
OTO - NOTNLM
OT  - mitral stenosis
OT  - pulmonary function test
OT  - pulmonary hypertension
COIS- Conflict of interest: None.
EDAT- 2014/06/18 06:00
MHDA- 2014/06/18 06:01
PMCR- 2014/06/01
CRDT- 2014/06/18 06:00
PHST- 2013/07/05 00:00 [received]
PHST- 2014/03/04 00:00 [revised]
PHST- 2014/03/05 00:00 [accepted]
PHST- 2014/06/18 06:00 [entrez]
PHST- 2014/06/18 06:00 [pubmed]
PHST- 2014/06/18 06:01 [medline]
PHST- 2014/06/01 00:00 [pmc-release]
AID - IMAS_6(2014)2/4 [pii]
AID - 10.1556/IMAS.6.2014.2.4 [doi]
PST - ppublish
SO  - Interv Med Appl Sci. 2014 Jun;6(2):75-84. doi: 10.1556/IMAS.6.2014.2.4. Epub 2014 
      Jun 4.