000			05681nam a22008417a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a1471-2261
024			_a10.1186/s12872-024-03932-w [pii]
024			_aPMC11184739 [pmc]
040			_aOvid MEDLINE(R)
099			_a38890637
245			_aImpact of commissural calcification on clinical outcome of percutaneous balloon mitral valvuloplasty; a retrospective cohort study of 876 patients.
251			_aBMC Cardiovascular Disorders. 24(1):309, 2024 Jun 18.
252			_aBMC Cardiovasc Disord. 24(1):309, 2024 Jun 18.
253			_aBMC cardiovascular disorders
260			_c2024
260			_fFY2024
260			_p2024 Jun 18
265			_sepublish
265			_tMEDLINE
266			_d2024-08-07
266			_z2024/06/18 23:46
501			_aAvailable online from MWHC library: 2001 - present
520			_aBACKGROUND: Percutaneous balloon mitral valvuloplasty (PBMV) is the ACC/AHA class I recommendation for treating symptomatic rheumatic mitral stenosis with suitable valve morphology, less than moderate MR and absence of left atrium clot. The mitral valve restenosis and significant mitral regurgitation (MR) are known adverse outcomes of PBMV. This study aimed to evaluate the outcomes of PBMV in patients with severe mitral stenosis and the effect of Commissural Calcification (CC) on the outcomes.
520			_aCONCLUSION: Commissural calcification (CC) is an independent predictor of the significant symptomatic MR (an important determinant of adverse outcome) following PBMV in the early and mid-term follow-up. Mitral valve restenosis occurs more in patients with higher Wilkins score compared to group I with score <= 8. Combined Wilkins score and CC should be considered for patient suitability for PBMV. Copyright © 2024. The Author(s).
520			_aMETHODS: In this single-center retrospective cohort study, 876 patients who underwent PBMV were categorized into three groups based on their Wilkins score (Group I: score <= 8, Group II: score 9-10, and Group III: score 11-12). Patients were evaluated before, early after PBMV and at 6- and 24-month follow-ups. Main clinical outcomes were defined as significant restenosis and or symptomatic significant MR (moderate to severe and severe MR) or candidate for mitral valve replacement (MVR). The outcomes were compared between patients with and without CC.
520			_aRESULTS: A total of 876 patients with mean age 46.4 +/- 12.3 years (81.0% females) were categorized based on Wilkins score. 333 (38.0%) were in Group I, 501 (57.2%) were in Group II, and 42 (4.8%) were in Group III. CC was present in 175 (20.0%) of the patients, among whom 95 (54.3%) had calcification of the anterolateral commissure, 64 (36.6%) had calcification of the posteromedial commissure, and in 16 (9.1%) patients both commissures were calcified. There was a significant difference in Wilkins score between patients with and without CC (P < 0.001). CC was associated with higher odds of significant symptomatic MR at early and mid-term follow up (OR: 1.69, 95%CI 1.19-2.41, P = 0.003; and OR: 3.90, 95%CI 2.61-5.83, P < 0.001, respectively), but not with restenosis (P = 0.128). Wilkins Groups II and III did not show higher odds of significant symptomatic MR compared to Group I at early (II: P = 0.784; III: P = 0.098) and mid-term follow up (II: P = 0.216; III: P = 0.227). Patients in Wilkins Group II had higher odds of restenosis compared to Group I (OR: 2.96,95%CI: 1.35-6.27, P = 0.007).
546			_aEnglish
650			_a*Balloon Valvuloplasty
650			_a*Calcinosis
650			_a*Mitral Valve
650			_a*Mitral Valve Insufficiency
650			_a*Mitral Valve Stenosis
650			_a*Severity of Illness Index
650			_aAdult
650			_aBalloon Valvuloplasty/ae [Adverse Effects]
650			_aCalcinosis/dg [Diagnostic Imaging]
650			_aCalcinosis/th [Therapy]
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aMitral Valve Insufficiency/dg [Diagnostic Imaging]
650			_aMitral Valve Insufficiency/et [Etiology]
650			_aMitral Valve Insufficiency/pp [Physiopathology]
650			_aMitral Valve Insufficiency/su [Surgery]
650			_aMitral Valve Insufficiency/th [Therapy]
650			_aMitral Valve Stenosis/dg [Diagnostic Imaging]
650			_aMitral Valve Stenosis/pp [Physiopathology]
650			_aMitral Valve Stenosis/su [Surgery]
650			_aMitral Valve Stenosis/th [Therapy]
650			_aMitral Valve/dg [Diagnostic Imaging]
650			_aMitral Valve/pp [Physiopathology]
650			_aMitral Valve/su [Surgery]
650			_aRecovery of Function
650			_aRecurrence
650			_aRetrospective Studies
650			_aRheumatic Heart Disease/co [Complications]
650			_aRheumatic Heart Disease/dg [Diagnostic Imaging]
650			_aRheumatic Heart Disease/pp [Physiopathology]
650			_aRheumatic Heart Disease/th [Therapy]
650			_aRisk Factors
650			_aTime Factors
650			_aTreatment Outcome
650			_zAutomated
651			_aMedStar Health Research Institute
657			_aJournal Article
700			_aSadeghpour, Anita _bMHRI
790			_aRostambeigi S, Mazaherinia H, Hamidabad NM, Kelsey AM, Alizadehasl A, Harandi STH, Farnoud K, Panahi P, Firouzi A, Sadeghpour A
856			_uhttps://dx.doi.org/10.1186/s12872-024-03932-w _zhttps://dx.doi.org/10.1186/s12872-024-03932-w
858			_ySadeghpour, Anita _uhttps://orcid.org/0000-0002-8485-0058 _zhttps://orcid.org/0000-0002-8485-0058
942			_cART _dArticle
999			_c14579 _d14579