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Case Reports
. 2018 Feb;5(1):193-196.
doi: 10.1002/ehf2.12238. Epub 2017 Nov 23.

Mitral valve pressure gradient after percutaneous mitral valve repair: every beat counts

Daniel Lavall  1 , Bruno Scheller  1 , Christian Werner  1 , Axel Buob  1 , Felix Mahfoud  1
Affiliations
Case Reports

Mitral valve pressure gradient after percutaneous mitral valve repair: every beat counts

Daniel Lavall et al. ESC Heart Fail. 2018 Feb.

Abstract

A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His-bundle ablation because atrial fibrillation was refractory to medical treatment. During biventricular pacing at different rates (50-110 b.p.m.), heart rate correlated positively with both MV mean pressure gradient and global longitudinal strain and negatively with stroke volume. MV pressure gradients directly translated into elevated pulmonary pressures. Thus, rate control and biventricular pacing improved cardiac haemodynamics.

Keywords: Global longitudinal strain; Heart rate; Mitral valve pressure gradient; Percutaneous mitral valve repair; Pulmonary pressures.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Correlation between heart rate and key haemodynamic measurements derived from echocardiography. Heart rate (HR) correlates with (A) mean mitral valve pressure gradient (MVPG), (B) right ventricular systolic pressure (RVSP), (C) stroke volume (SV), (D) cardiac output (CO), and (E) global longitudinal strain (GLS). (F) Correlation of MVPG with RVSP. The lines represent the non‐linear regression curve. Pearson correlation coefficients were computed. P‐values < 0.05 were considered to be statistically significant.
See this image and copyright information in PMC

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