{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:43:38Z","timestamp":1762868618298,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary hypertension (PH) is a marker of poor outcome in mitral stenosis (MS), which improves after percutaneous mitral valvuloplasty (PMV). However, mechanical interventions for relief of valve obstruction often but not always reduce pulmonary pressures. This study aimed to assess the parameters associated with abnormal pulmonary artery pressure (PAP) response immediately after a successful PMV, and also its impact on long\u2010term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 181 patients undergoing PMV for rheumatic MS were prospectively enrolled. Invasive hemodynamic and echocardiographic measures were examined in all patients. Abnormal PAP response was defined as the mean PAP (mPAP) values unchanged at the end of the procedure. Long\u2010term outcome was a composite endpoint of death, mitral valve replacement, repeat PMV, new onset of atrial fibrillation (AF), or stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 44.1\u2009\u00b1\u200912.6\u2009years, and 157 patients were women (86.7%). In the overall population, mPAP decreased from 33.4\u2009\u00b1\u200913.1\u2009mmHg pre to 27.6\u2009\u00b1\u20099.8\u2009mmHg post (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Following PMV, 52 patients (28.7%) did not have any reduction of mPAP immediately after the PMV. Multivariable analysis adjusting for baseline values of PAP and mitral valve area revealed that AF (Odds ratio [OR] 2.7, 95% [confidence interval] CI 1.3 to 6.7), maximum mitral valve leaflets displacement (OR 0.8, 95% CI 0.7 to 0.9), and post\u2010procedural left ventricular compliance (OR 0.7, 95% CI 0.5 to 0.9) were predictors of a lack of improvement in mPAP. During a median follow\u2010up of 4.4\u2009years, the endpoint was reached in 56 patients (31%). The pulmonary pressure response to PMV was not an independent predictor of long\u2010term events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with MS undergoing PMV, pulmonary pressures may not reduce immediately after the procedure, despite adequate opening of the valve. Abnormal PAP response can be predicted from baseline clinical and valvular characteristics as well as post\u2010procedural left ventricular compliance. The lack of any immediate reduction in mPAP is not associated with long\u2010term adverse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29926","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T15:07:42Z","timestamp":1629472062000},"page":"915-923","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pulmonary artery pressure response to percutaneous mitral valvuloplasty: Associated factors and clinical implications"],"prefix":"10.1002","volume":"99","author":[{"given":"Igor","family":"Ferreira de Sales","sequence":"first","affiliation":[{"name":"Postgraduate Course of Infectious Diseases and Tropical Medicine, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Brazil"},{"name":"Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte 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Universidade Federal de Minas Gerais  Belo Horizonte Brazil"},{"name":"Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana","family":"Costa Diamantino","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Campos Barbosa e Silva","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederico","family":"Vargas Botinha Macedo","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, School of Medicine Universidade Federal de Minas Gerais  Belo Horizonte 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