Related Experiment Video
Updated: Jan 26, 2026
Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat
Published on: November 18, 2018
Prognostic Implications of the Left Atrial Volume Index in Patients with Progressive Mitral Stenosis
In Jeong Cho1, Hyeonju Jeong2, Jah Yeon Choi3
1Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Background:
Limited data are available on the prognosis of progressive mitral stenosis (MS). We evaluated the factors associated with adverse events in patients with progressive MS.
Methods:
We retrospectively analyzed 259 consecutive patients with pure progressive MS with a mitral valve area (MVA) between 1.5 and 2.0 cm². The primary outcome measures were a composite endpoint of cardiac death, heart failure hospitalization, mitral valve surgery or percutaneous mitral valvuloplasty, and ischemic stroke.
Results:
The mean patient age was 62 ± 12 years, and the mean MVA was 1.71 ± 0.15 cm². Over a median follow-up duration of 52 months, a total of 41 patients (18.3%) experienced the composite endpoint. In multivariable Cox regression analysis, prior stroke (hazard ratio [HR], 4.54; 95% confidence interval [CI], 2.16-9.54; p < 0.001) and left atrial volume index (LAVI) of > 50 mL/m² (HR, 4.45; 95% CI, 1.31-15.31; p = 0.017) were identified as independent predictors of the composite endpoint, even after adjusting for age and sex. Patients with a LAVI ≤ 50 mL/m² demonstrated favorable event-free survival compared with those with a LAVI > 50 mL/m² in either the overall population (p < 0.001) or asymptomatic patients (p = 0.002). Atrial fibrillation (AF), left ventricular mass index (LVMI), MVA, and mean diastolic pressure were factors independently associated with LAVI (all p < 0.05).
Conclusions:
A deleterious impact of a high LAVI on outcome was observed in patients with progressive MS. The LAVI was mainly influenced by the presence of AF, the severity of MS, and LVMI in this population.
Insights
Progressive mitral stenosis (MS) prognosis is poorly understood. A high left atrial volume index (LAVI) predicts adverse events in MS patients, influenced by atrial fibrillation, MS severity, and left ventricular mass.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Prognosis and predictive factors for adverse events in progressive mitral stenosis (MS) remain understudied.
- Limited data exist on the long-term outcomes for patients with progressive MS.
Purpose of the Study:
- To investigate the factors associated with adverse clinical outcomes in patients diagnosed with progressive mitral stenosis.
- To identify predictors of cardiac death, heart failure hospitalization, or interventions in this patient cohort.
Main Methods:
- Retrospective analysis of 259 patients with pure progressive mitral stenosis (MVA 1.5-2.0 cm²).
- Primary composite endpoint included cardiac death, heart failure hospitalization, mitral valve surgery/valvuloplasty, and ischemic stroke.
- Multivariable Cox regression analysis was employed to identify independent predictors.
Main Results:
- A composite endpoint occurred in 18.3% of patients over a median follow-up of 52 months.
- Prior stroke (HR 4.54) and left atrial volume index (LAVI) > 50 mL/m² (HR 4.45) were independent predictors of adverse events.
- Lower LAVI (≤ 50 mL/m²) was associated with significantly better event-free survival (p < 0.001).
Conclusions:
- Elevated LAVI is a significant negative prognostic factor in progressive mitral stenosis.
- LAVI is influenced by atrial fibrillation, MS severity, and left ventricular mass index.
- Left atrial volume index serves as a crucial marker for risk stratification in progressive MS.
More Related Videos
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
07:28Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Related Concept Videos
01:22Mitral Stenosis I: Introduction
01:26Mitral Stenosis III: Medical Management
01:27Mitral Stenosis IV: Nursing Management
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
01:20Mitral Regurgitation I: Introduction