Degenerative Mitral Stenosis Versus Rheumatic Mitral Stenosis.

Area of Science:

• Cardiology
• Echocardiography
• Valvular Heart Disease

Background:

• Rheumatic disease (RMS) is the classic cause of mitral stenosis.
• Degenerative mitral stenosis (DMS) is increasingly prevalent in aging populations.
• Comparing clinical and echocardiographic features of DMS and RMS is crucial.

Purpose of the Study:

• To compare clinical and echocardiographic characteristics of degenerative mitral stenosis (DMS) and rheumatic mitral stenosis (RMS).
• To investigate differences in patient demographics, comorbidities, and echocardiographic parameters between DMS and RMS.

Main Methods:

• Retrospective analysis of 115 DMS patients from the US and 510 RMS patients from Korea.
• Inclusion criteria: mitral valve area (MVA) ≤2.5 cm² by continuity equation.
• Comparison of clinical data and echocardiographic measurements.

Main Results:

• DMS patients were older with more comorbidities (hypertension, diabetes, CKD, COPD) than RMS patients.
• DMS showed a higher MVA (1.35 vs 0.95 cm²) and lower mean gradient (7.63 vs 8.50 mm Hg) compared to RMS, despite similar MVA criteria.
• Higher stroke volume in DMS patients (70.4 vs 55.7 ml) explained the greater MVA relative to gradient.

Conclusions:

• Degenerative mitral stenosis patients present with distinct clinical and echocardiographic profiles compared to rheumatic mitral stenosis.
• DMS is associated with advanced age and higher comorbidity burden.
• Echocardiographic findings in DMS suggest a higher mitral valve area relative to the pressure gradient, driven by increased stroke volume.