Background: Studies for PTMC limited to the study of mitral valve had made challenges to the study of multivalve lesions that includes the aortic valve. Clinical outcomes in Rheumatic mitral stenosis (MS) post PTMC with aortic valve involvement must have an association with echocardiographic factors that would guide clinicians in prognostication. This study aims to demonstrate the association between the echocardiographic parameters of Rheumatic MS patients with aortic valve involvement with 1-year composite clinical outcome of patients who underwent PTMC
Method: This is a cohort study that included all patients, 19-65 years old, diagnosed with Rheumatic MS with aortic valve involvement, who underwent PTMC. Immediate 2D Echo of patients done post-PTMC was reviewed. Patients were then followed-up and composite clinical outcomes noted which may include major adverse cardiac events, stroke, infective endocarditis and surgical operation were noted.
Results: The study included 72 patients who were grouped based on the presence or absence of composite clinical outcomes. Fifteen patients were noted in the group with composite clinical outcome; There is a statistically significant association of composite clinical outcome with the following echocardiographic factors: abnormal left atrial volume index with of OR 1.26 (95% CI= 1.08 to 1.48), p=0.003, presence of aortic regurgitation with OR of 42 (95% CI= 5.0 to 352), p=0.001, particularly those with mild regurgitation, and those with abnormal aortic valve area with OR of 10 (95% CI= 1.63 to 61.5), p=0.013, and aortic valve gradient with OR of 10 (95% CI= 1.63 to 61.5), p=0.013.
Conclusion: This study showed that abnormal left atrial volume index, presence of aortic regurgitation with abnormal aortic valve area and gradients immediately post-PTMC is associated with composite clinical outcomes.