{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:06:08Z","timestamp":1778864768279,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,23]],"date-time":"2018-09-23T00:00:00Z","timestamp":1537660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004901","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de Minas Gerais","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004901","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Conventional hemodynamic parameters may not accurately predict symptomatic improvement after percutaneous mitral valvuloplasty (PMV). Changes in left heart chamber compliance following adequate relief o0066 mitral stenosis (MS) may be useful in determining functional capacity after PMV. This study aims to determine the acute effects of PMV on compliance of the left heart and whether its changes relate to the patient's functional capacity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One\u2010hundred thirty\u2010seven patients with severe MS undergoing PMV were enrolled. Left atrial (<jats:italic>C<\/jats:italic><jats:sub>a<\/jats:sub>) and left ventricular (<jats:italic>C<\/jats:italic><jats:sub>v<\/jats:sub>) compliance were invasively estimated and net atrioventricular compliance (<jats:italic>C<\/jats:italic><jats:sub>av<\/jats:sub>) was calculated before and immediately after the procedure. B\u2010type natriuretic peptide (BNP) levels were obtained before and 24\u2009hr after the procedure. The primary endpoint was functional status at 6\u2010month follow\u2010up, and the secondary endpoint was a composite of death, mitral valve (MV) replacement, repeat PMV, new onset of atrial fibrillation, or stroke in patients in whom PMV was successful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 43\u2009\u00b1\u200912\u2009years, and 119 patients were female (87%). After PMV, <jats:italic>C<\/jats:italic><jats:sub>a<\/jats:sub> and <jats:italic>C<\/jats:italic><jats:sub>av<\/jats:sub> improved significantly from 5.3 [IQR 3.2\u20138.2] mL\/mmHg to 8.7 [5.3\u201319.2] mL\/mmHg (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 2.2 [1.6\u20133.4] to 2.8 [2.1\u20134.1] mL\/mmHg (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), respectively, whereas <jats:italic>C<\/jats:italic><jats:sub>v<\/jats:sub> did not change (4.6 [3.2\u20136.8] to 4.4 [3.1\u20135.6]; <jats:italic>P<\/jats:italic>\u2009=\u20090.637). Plasma BNP levels significantly decreased after PMV, with no correlation between its variation and changes in left chamber compliance. At 6\u2010month follow\u2010up, NYHA functional class remained unchanged in 32 patients (23%). By multivariable analyses, changes in <jats:italic>C<\/jats:italic><jats:sub>a<\/jats:sub> immediately after PMV (adjusted OR 1.42; 95% CI 95% 1.02 to 1.97; <jats:italic>P<\/jats:italic>\u2009=\u20090.037) and younger age (adjusted OR 0.95; CI 95% 0.92\u20130.98; <jats:italic>P<\/jats:italic>\u2009=\u20090.004), predicted improvement in functional capacity at 6\u2010month follow\u2010up, independent of postprocedural data. The secondary endpoint were predicted by post\u2010PMV mean gradient (adjusted HR 1.363; 95% CI 95% 1.027\u20131.809; <jats:italic>P<\/jats:italic>\u2009=\u20090.032), and lack of functional improvement at 6\u2010month follow\u2010up (adjusted HR 4.959; 95% 1.708\u201314.403; <jats:italic>P<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>\n<jats:italic>C<\/jats:italic><jats:sub>a<\/jats:sub> and <jats:italic>C<\/jats:italic><jats:sub>av<\/jats:sub> increase significantly after PMV with no change in <jats:italic>C<\/jats:italic><jats:sub>v<\/jats:sub>. The improvement of <jats:italic>C<\/jats:italic><jats:sub>a<\/jats:sub> is an important predictor of functional status at 6\u2010month follow up, independently of other hemodynamic data. Postprocedural mean gradient and lack of short\u2010term symptomatic improvement were predictors of adverse outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27831","type":"journal-article","created":{"date-parts":[[2018,9,23]],"date-time":"2018-09-23T12:29:44Z","timestamp":1537705784000},"page":"156-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of left atrial compliance improvement on functional status after percutaneous mitral valvuloplasty"],"prefix":"10.1002","volume":"93","author":[{"given":"Guilherme Rafael Sant'Anna","family":"Athayde","sequence":"first","affiliation":[{"name":"Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"},{"name":"Cardiology and Cardiovascular Surgery Division, Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5586-774X","authenticated-orcid":false,"given":"Bruno Ramos","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiovascular Surgery Division, Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sammy","family":"Elmariah","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School  Boston MA"},{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-3048","authenticated-orcid":false,"given":"Lucas","family":"Lodi\u2010Junqueira","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiovascular Surgery Division, Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana Rodrigues","family":"Soares","sequence":"additional","affiliation":[{"name":"Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"},{"name":"Cardiology and Cardiovascular Surgery Division, Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Prado","family":"Saad","sequence":"additional","affiliation":[{"name":"Cardiology and Cardiovascular Surgery Division, Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Luiz Padilha","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Statistics Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy C.","family":"Tan","sequence":"additional","affiliation":[{"name":"Cardiac Ultrasound Lab Massachusetts General Hospital, Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy","family":"Hung","sequence":"additional","affiliation":[{"name":"Cardiac Ultrasound Lab Massachusetts General Hospital, Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor F.","family":"Palacios","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School  Boston MA"},{"name":"Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston 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