Echocardiographic Parameters Correlated with Age in Isolated Severe Rheumatic Mitral Stenosis Patients in Indonesia

Abstract

BACKGROUND: Despite the high prevalence of rheumatic mitral stenosis (MS) in Indonesia, the impact of aging on the anatomical and hemodynamic component of rheumatic MS is not well studied.

AIM: To analyze the association of age with various echocardiographic parameters in patients with isolated severe rheumatic MS in Indonesia.

METHODS: A cross-sectional study was conducted enrolling 263 subjects with isolated severe rheumatic MS who underwent transthoracic echocardiography (TTE) during January 2015 until December 2017 at National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia. Demographic data were collected, and echocardiographic variables were measured based on standard TTE examination using GE Vivid 7 and S6 Doppler Echocardiography System (GE Medical System, Norway).

RESULTS: Of 263 subjects, there are 84 men and 179 women aged 18-80 (mean age 42.9) years old. Most patients had atrial fibrillation (80%), with a higher prevalence of AF in the older group. Age was positively correlated with LA diameter and Wilkin’s score (r = 0.186, P = 0.002; r = 0.142, P = 0.022; respectively); while mean MVG (r = -0.304, P < 0.001), TR Vmax (r = -0.126, P = 0.04), TR maxPG (r = -0.127, P = 0.039) and TAPSE (r = -0.125, P = 0.044) were correlated negatively with age. Mean MVG has the strongest correlation with age in our subjects.

CONCLUSION: This is the first study in Indonesia that analyze the association of age and different echocardiographic parameters in isolated severe rheumatic severe MS patients. Age has a significant correlation with mean MVG, LA diameter, Wilkin’s score, TR Vmax, TR maxPG, and TAPSE. We assume that the association of age and these parameters were influenced by the normal aging process and progression of chronic MS.