[Evaluation of changes in pulmonary vein compliance in prognosis of clinical results after mitral valve replacement].

Irreversible decrease in pulmonary venous compliance (PVcomp) can influence on the clinical results of mitral valve replacement (MVR). The study has been aimed at assessing whether changes in the PVcomp after the application of isosorbiddinitrate (ISDN) can be of prognostic significance in pts with mitral stenosis (MS). Right heart catheterization was performed with 34 pts with MS using a Swan-Ganz catheter in supine position, before and after the application of ISDN. Pulmonary artery pressure (PAP), pulmonary wedge pressure (PWP), stroke volume index (SVI), pulmonary vascular resistance (PVR) and heart rate (HR) were calculated according to standard formulas: PVcomp was calculated according to Hirakawa equation. The whole group was divided into 2 subgroups: I--increase of PVcomp after ISDN > 15% (19 pts), II--decrease or no change of PVcomp after ISDN (15 pts). ISDN increased PVcomp from 5.27 to 8.08. ml/m3 in group I, and decrease from 6.74 to 6.31 ml/m3 in group II. There were no differences between both groups during rest and effort before MVR. Six months after MVR decrease in PAP, PWP, PVR and increase in SVI was observed in both groups, but more significant in group I. However during effort (25 W), significant increases in PAP (21.9 vv 36.5 mmHg), PWP (12.9 vs 24.5 mmHg) and HR (80 vs 98 beat/min) with no improvement of PVcomp (5.82 vs 5.68 ml/m2) were recorded in most of pts from group II as opposed to group I. As can be concluded, significant increase in PVcomp after ISDN in pts with MS can be a prognostic of good clinical results after MVR.