Effect of Cardiac Rhythm on Hemodynamic Changes and Pulmonary Arterial Atrial Natriuretic Peptide Levels after Percutaneous Mitral Valvuloplasty

Lee, Myoung Mook; Park, Seung Woo; Choi, Sung Joo; Choi, Dong Ju; Kim, Cheol Ho; Sohn, Dae Won; Seo, Jung Don; Lee, Young Woo

Abstract

In order to evaluate the effect of cardiac rhythm on hemodynamic changes and pulmonary arterial atrial natriuretic peptide(ANP) levels after percutaneous mitral valvuloplasty(PMV), we measured and analyzed the correlations between hemodynamic parameters and pulmonary arterial ANP levels in 65 patients with mitral stenosis before, 20 minutes, and 24 hours after PMV. The results are as follows: 1) Normal sinus rhythm was present in 49 patients(group1), whereas the other sixteen (group 2) had chronic atrial fibrillation. 2)PMV decreased mean left atrial pressure(LAP) in both groups(p<0.001). Left atrial volume was also reduced after PMV in group 1(p<0.0001), whereas it was not decreased significantly in group 2. 3) Pulmonary arterial ANP levels at 24 hours after PMV decreased significantly in group 1(p<0.001), compared to those prior to PMV. However there was no significantl changes in group 2. 4) In group 1, there was a significant linear relationship between extents of drop in pulmonary arterial ANP levels and LAP, measured 24hours after PMV. These results suggest that ANP secretion might be influenced not only by hemodynamic changes of the left atrium, but also by possible structural changes of left atrial wall induced by chronic atrial fibrillation.