{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:01:27Z","timestamp":1761102087999},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,10,11]],"date-time":"2013-10-11T00:00:00Z","timestamp":1381449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Conventional stenosis indexes poorly reflect the major hemodynamic consequence of mitral stenosis (<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>). Valve resistance (<jats:styled-content style=\"fixed-case\">VR<\/jats:styled-content>) is a physiologic expression of stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to demonstrate whether the mitral valve resistance (<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>) and its changes, relate to restricted exercise capacity in patients with mild and moderate mitral stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010four patients with rheumatic mild\u2010to\u2010moderate<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>underwent transthoracic echocardiographic study (resting and dobutamine stress echocardiography [<jats:styled-content style=\"fixed-case\">DSE<\/jats:styled-content>]), divided into two groups; group I: symptomatic (12 patients) and group<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>: asymptomatic (12 patients). Mitral valve area (<jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content>), mean transmitral diastolic pressure gradient (<jats:styled-content style=\"fixed-case\">TMPG<\/jats:styled-content>), cardiac output (<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>), and<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>were measured in all patients at rest and at peak<jats:styled-content style=\"fixed-case\">DSE<\/jats:styled-content>. Changes (\u2206) in<jats:styled-content style=\"fixed-case\">MVA<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">TMPG<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>, and<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>were calculated. Data underwent statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From resting to peak dobutamine infusion, the<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>significantly decreased from 111.4\u00a0\u00b1\u00a028.2 to 83.6\u00a0\u00b1\u00a027.0\u00a0dynes sec\/cm<jats:sup>5<\/jats:sup>in group<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>(P\u00a0&lt;\u00a00.001). The increase in<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>in group I (13.8\u00a0\u00b1\u00a010.3\u00a0dynes sec\/cm<jats:sup>5<\/jats:sup>) compared with its reduction (\u221227.8\u00a0\u00b1\u00a015.6\u00a0dynes sec\/cm<jats:sup>5<\/jats:sup>) in group<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>were highly significant different (P\u00a0&lt;\u00a00.001). A reduction in<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>by less than 21.5\u00a0dynes sec\/cm<jats:sup>5<\/jats:sup>at peak dobutamine infusion reflect a cutoff value considered to detect the hemodynamic significance of mild\u2010to\u2010moderate<jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content>with a sensitivity of 92% and a specificity of 73%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The changes in the<jats:styled-content style=\"fixed-case\">MVR<\/jats:styled-content>can be used as a<jats:styled-content style=\"fixed-case\">DSE<\/jats:styled-content>parameter for expression of stenosis severity and to describe discrepancy in symptom status in patients with mild\u2010to\u2010moderate mitral 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