[Usefulness of carotid sinus massage for Doppler quantification of mitral stenosis in sinus rhythm]

The quantification of mitral stenosis by pressure half-time method may be difficult in sinus rhythm with short deceleration slopes. To evaluate the usefulness of carotid sinus massage (CSM) for measuring mitral valve area by pressure half-time, 80 consecutive patients with mitral stenosis in sinus rhythm underwent a echo-Doppler study at basal heart rate and during right CSM. In both situations we measured: heart rate, mitral area by pressure half-time and E-F interval (time from E peak velocity to onset of atrial contraction). In 38 consecutive patients we also determined the mitral area by planimetry. The study group was divided into patients with basal E-F interval < or = 150 ms and a HR > or = 75 bpm (group A, 28 patients [35%]) and those with a basal E-F interval > 150 ms who showed a heart rate < 75 bpm (group B, 52 patients). In the group A, the values obtained at basal heart rate vs after CSM were: heart rate, 86 +/- 9 vs 61.6 +/- 10.5 lpm; E-F interval, 109 +/- 33 vs 372 +/- 136 ms; mitral area, 1.88 +/- 0.5 vs 1.23 +/- 0.29 cm2 (p < 0.001). In the group B, these values were: 69.7 +/- 6.6 vs 53 +/- 11 bpm, 253 +/- 60 vs 510 +/- 212 ms y 1.34 +/- 0.3 vs 1.18 +/- 0.32 cm2, respectively (p < 0.01). Mean differences in Doppler mitral areas between both situations for groups A and B were: 0.63 +/- 0.3 cm2 and 0.17 +/- 0.1 cm2, respectively (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)