Rheumatic Mitral Stenosis: Correlation Between Mitral Valve Area and Hemodynamic and Echocardiographic Parameters

Background: The relationship between mitral valve area (MVA) and different hemodynamic and echocardiographic parameters is not well defined. This study aimed to assess whether hemodynamic and echocardiographic parameters correlated with MVA in patients with rheumatic mitral stenosis. Methods: This cross-sectional study assessed 600 patients with rheumatic heart disease who underwent transthoracic echocardiography in a tertiary care center between August 2018 and March 2020. Among them, 265 cases of predominant mitral stenosis were enrolled. Demographic data, as well as hemodynamic and echocardiographic variables, were recorded. Results: Out of the 265 patients, 29.1% were males, and 71.9% were females at a mean age of 44.80 +/- 13.54 years. MVA ranged between 0.5 cm(2) and 2.0 cm(2), with a mean mitral valve gradient of 10.02 +/- 3.43 mm Hg. Atrial fibrillation was present in 44.2%. There were positive correlations between MVA and body mass index (r=0.19, P=0.002), systolic blood pressure (r=0.14, P=0.011), diastolic blood pressure (r=0.16, P=0.006), and mean blood pressure (r=0.18, P=0.003). Negative correlations were found between MVA and heart rate (r= -0.20, P=0.001), left atrial size (r= -0.16, P=0.007), mean mitral valve gradient (r= -0.67, P<0.001), and pulmonary artery systolic pressure (r= -0.17, P=0.004). Conclusions: MVA correlated significantly with body mass index, blood pressure, heart rate, left atrial size, mean mitral valve gradient, and pulmonary artery systolic pressure. This study helps to understand the influence of different clinical parameters and transthoracic echocardiographic findings to accurately assess rheumatic mitral stenosis severity.