{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:59:58Z","timestamp":1747184398916,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T00:00:00Z","timestamp":1648944000000},"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":["Echocardiography"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In our institute, the causes of mitral stenosis (MS) are generally categorized into three main etiologies\u2014rheumatic MS (RMS), degenerative MS with annular and leaflet calcification, and post\u2010clip MS as a consequence of transcatheter mitral valve repair with clips for treating mitral regurgitation. However, clinical differences among the three etiologies are uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively assessed 293 consecutive patients (53 with RMS, 118 with degenerative MS, and 122 with post\u2010clip MS) who had a three\u2010dimensional (3D) transesophageal echocardiography (TEE) derived mitral valve orifice area (MVA) of \u22641.5\u00a0cm<jats:sup>2<\/jats:sup>, and a mean transmitral pressure gradient of \u22655 mmHg on transthoracic echocardiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although there was no difference in 3D\u2010TEE\u2010derived MVA among the three groups, patients with post\u2010clip MS had a significantly lower mean transmitral pressure gradient compared to those with either of the other two types of MS (10.8 ([7.9\u201315.2] mmHg vs. 9.6 [7.3\u201312.5] mmHg vs. 6.9 [6.0\u20139.2] mmHg; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Patients with RMS had a higher prevalence of dyspnea. The independent determinants of dyspnea were pressure half time in RMS, 3D\u2010TEE\u2010derived MVA and estimated right atrial pressure in degenerative MS, and left ventricle ejection fraction in post\u2010clip MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with post\u2010clip MS had the lowest mean transmitral pressure gradient, and patients with RMS had the highest prevalence of dyspnea, despite having a similar 3D\u2010TEE\u2010derived MVA. The determinants of dyspnea were different among the three etiologies of MS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15348","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T02:18:36Z","timestamp":1649038716000},"page":"691-700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and echocardiographic differences in three different etiologies of severe mitral stenosis"],"prefix":"10.1111","volume":"39","author":[{"given":"Shunsuke","family":"Kagawa","sequence":"first","affiliation":[{"name":"Smidt Heart Institute Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taku","family":"Omori","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute Cedars\u2010Sinai Medical Center  Los Angeles California 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