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Mitral stenosis is still one of cause of morbidity and mortality. The association of mitral stenosis and ventricular dysfunction was proven in previous studies; while the relationship between mitral stenosis and coronary artery blood flow hasn't been studied yet. We investigated the correlation between isolated severe mitral stenosis and coronary artery blood flow reserve in this study.
The patients with severe mitral stenosis, diagnosed by quantitative methods, were included in this study. Left anterior descending artery blood flow was evaluated by coronary presets and pulse wave Doppler ultrasonography. After injection of dipyridamole on basal conditions hyperemic systolic and diastolic blood flows were evaluated and blood flow reserve was calculated. Percutaneous balloon valvuloplasty was performed in all the patients and coronary artery blood flow reserve was re-evaluated. The values before and after the intervention were compared.
Twenty patients were included in this study (14 male and 6 female; mean age 44.4). After the intervention peak blood flow velocities were found to be significantly increased in basal and hyperemic systolic (basal systolic blood flow velocity 12,0±1,85 cm/s vs. 14,75±1,28 cm/s p=0,009, hyperemic systolic blood flow velocity 17,62±4,83 cm/s vs. 24,50±7,15 cm/s p=0,018) and diastolic (basal diastolic blood flow velocity 21,62±5,70 cm/s vs. 31,00±7,07 cm/s p=0,02, hyperemic diastolic blood flow velocity 44,62±10,14 cm/s vs. 52,62±11,57 cm/s p=0,002) blood flows. However the difference on coronary artery reserve values were not found to be statistically significant (diastolic coronary blood flow reserve 2,14±0,54 vs. 1,71±0,27 p=0,05, systolic coronary artery blood flow reserve 1,46±0,29 vs. 1,67±0,50 p=0,30).
Percutaneous balloon valvuloplasty increases the coronary artery blood flow without affecting coronary artery blood flow reserves. Low coronary artery blood flow may be an etiological factor on subclinical left ventricular dysfunction in isolated mitral stenosis patients.