[Analysis of airway function in patients with mitral valve disease in various stages of progression]

The aim of the study was to assess an airway function in patients with mitral valve disease at different stages. The study group consisted of 105 consecutive patients with rheumatic mitral valve disease (21-20% pts with mitral stenosis and 84-80% with combined mitral valve disease with a stenosis prevalence). 77 (73%) females, 28 (27%) males, at a mean age 50.4 (28-68) years.

aortic valve disease, ischemic left ventricular damage, uncontrolled hypertension, pulmonary and allergic diseases. Each patient was assessed by clinical, echocardiographic, X-ray chest, electrocardiographic examination and airway function studies. An airway obstruction was diagnosed when MEF50 < 60% of predicted value or Raw > 0.3 kPa/lxs-1. To assess airway obstruction reversibility test with fenoterol was performed. In the others nonspecific bronchial provocation test with 0.1% histamine was assessed. Similar number of patients was qualified to II (37%), III (33%) and IV (30%) NYHA functional class. Airway function disturbances were diagnosed in 98 patients (93.5% of all). In most of them airway obstruction was observed (70.5%). Bronchial hyperreactivity was detected in 24 patients (23%). Both airway function disturbances could enhance dyspnoea and fatigue. In the whole study group significant correlations between airway parameters indicating peripheral obstruction or restriction and some cardiological parameters were found. This suggests that peripheral obstruction is proportional to development of a valvular heart disease. Airway resistance which generally represents in 80-90% function of main bronchi was not correlated with any of the analysed cardiological parameters. We conclude that central obstruction is an additional and independent of development of valvular disease part of airway function disturbances.