Mitral Valve Stenosis (Mitral Stenosis)

Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.

Also Known As:

Networked: 1305 relevant articles (46 outcomes, 122 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Mitral Valve Insufficiency (Mitral Regurgitation)
2.	Pulmonary Hypertension (Ayerza Syndrome)
3.	Aortic Valve Stenosis (Aortic Stenosis)
4.	Aortic Valve Insufficiency (Aortic Regurgitation)
5.	Dyspnea (Shortness of Breath)

Experts

1.	Korkmaz, Sule: 9 articles (09/2011 - 10/2006)
2.	Chang, Hsueh-Wen: 7 articles (07/2005 - 11/2003)
3.	Chen, Mien-Cheng: 7 articles (07/2005 - 11/2003)
4.	Wu, Chiung-Jen: 6 articles (07/2005 - 11/2003)
5.	Tarasoutchi, Flávio: 5 articles (01/2013 - 01/2002)
6.	Grinberg, Max: 5 articles (01/2013 - 01/2002)
7.	Demirkan, Burcu: 5 articles (09/2011 - 10/2006)
8.	Elcik, Deniz: 4 articles (07/2014 - 11/2011)
9.	Ozdogru, Ibrahim: 4 articles (01/2013 - 10/2007)
10.	Ting, Chih-Tai: 4 articles (09/2010 - 05/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Mitral Valve Stenosis:

1.	Atenolol (Tenormin)FDA LinkGeneric 03/01/2002 - "When patients were grouped into those in whom VO2max was improved with atenolol therapy (n = 7) and those in whom it was impaired (n = 10), there were no inter-group differences with respect to age, left ventricular function, severity of mitral stenosis, NYHA class and grade of beta-blockade reached. " 03/01/2002 - "The study aim was to determine whether beta-blocker treatment (atenolol) improves cardiopulmonary exercise performance and ventilatory response in patients with mitral stenosis in sinus rhythm. " 10/01/2000 - "The purpose of this study is to evaluate the short-term benefit of a beta-blocker (atenolol) on clinical and echocardiographic parameters of patients presenting isolated or predominant mitral stenosis in sinus rhythm. " 01/01/1995 - "We studied the effect of atenolol 100 mg/day in 50 symptomatic patients of mitral stenosis and normal sinus rhythm, in a placebo controlled study. " 01/01/1993 - "The hemodynamic effects of atenolol observed in this study appear to benefit the patients with mitral stenosis by reduction of pulmonary pressure, pulmonary capillary wedge pressure and mitral valve gradient. "
2.	Nitric Oxide (Nitrogen Monoxide)FDA Link 01/01/2009 - "Significant improvement in pulmonary vascular resistance in the responders and maintenance of high pressures despite iNO therapy in non-responders indicate that apart from some abnormality in nitric oxide pathway, some other factors may be a contributing in the causation of PH secondary to mitral stenosis in adults, which warrant further studies." 02/01/2004 - "The aims of the study were to evaluate the role of cardiopulmonary exercise testing in the assessment of patients with mitral stenosis and to quantify nitric oxide production at rest and at the end of exercise. " 02/01/2004 - "Cardiopulmonary exercise testing and exhaled nitric oxide in the assessment of patients with mitral stenosis." 04/01/2011 - "The aim of this study was to test the hypothesis that inhaled nitric oxide (iNO) would improve the hemodynamic effects and short-term clinical outcomes of patients with mitral stenosis and severe pulmonary hypertension who undergo cardiac surgery in a randomized, controlled study. " 07/01/2009 - "Variable response to inhaled nitric oxide (iNO) therapy in patients with mitral stenosis (MS) having pulmonary hypertension (PH) has been documented in early studies. "
3.	Warfarin (Coumadin)FDA LinkGeneric 02/01/2015 - "In all the trials comparing NOACs and warfarin, a significant percentage of patients presented any type of VHD, excluding rheumatic mitral stenosis and mechanical heart valve. " 01/01/2012 - "We excluded patients with warfarin at baseline, mitral stenosis, previous valvular surgery, or who died within 14 days from baseline. " 05/01/1995 - "Most physicians prescribed warfarin in AF associated with mitral stenosis (G vs C, 86% vs 89%, NS). " 12/01/2009 - "Balloon mitral commissurotomy for mitral stenosis after resolution of a large mobile left atrial thrombus by 2-year warfarin treatment." 01/01/2007 - "This report describes the management of a patient with severe symptomatic mitral stenosis and a large mobile thrombus extending from the left atrial appendage that was resistant to warfarin therapy. "
4.	Atrial Natriuretic Factor (ANF)IBA 12/01/2004 - "Left atrial diameter is a simple indicator of a deficiency in atrial natriuretic peptide secretion in patients with mitral stenosis: efficacy of postoperative supplementation with synthetic human alpha-atrial natriuretic peptide." 11/01/1993 - "The recent introduction of percutaneous transvenous mitral valvuloplasty (PTMV) for the treatment of mitral stenosis (MS) has provided a unique human model for the study of short-term changes in ANF secretion before and after a reduction in left atrial pressure. " 08/01/1988 - "To study the relation between plasma atrial natriuretic factor (ANF) and cardiac pressures, we measured plasma ANF in 24 patients with mitral stenosis 30 minutes before and 20 minutes after balloon mitral valvulotomy. " 12/01/2004 - "Left atrial diameter can be a simple and useful indicator of a deficiency in endogenous ANP secretion in patients with mitral stenosis, and postoperative ANP supplementation contributes to suppressing further activation of renin-angiotensin system during the immediate postoperative period." 12/01/2004 - "The maximum value of plasma ANP was 249.5 pg/mL accompanied with 56.2 mm of left atrial diameter in 29 patients suffering from mitral stenosis. "
5.	OxygenIBA 11/01/1995 - "To determine the acute influence of improvement in orifice area in mitral stenosis by percutaneous transluminal valvuloplasty (PTVP) on cardiopulmonary exercise capacity, treadmill walking time (TWT), oxygen uptake parameters at maximum exercise as well as at highest comparable workloads and parameters of breathing work were assessed pre- and post-PTVP. " 09/01/1966 - "[Clinical studies on the relationship between pulmonary circulation and respiratory function in mitral stenosis with special reference to the oxygen cost of breathing]." 01/01/1994 - "Indexed peak oxygen uptake was not correlated to delta oxygen pulse but was linearly related (r = 0.43) to delta heart rate (delta heart rate = peak heart rate/rest heart rate) in Group I but not in Group II. Thus, in patients with mitral stenosis, no correlation was found between the mitral valve area or the gradient at rest and maximal upright exercise tolerance, suggesting that peripheral adaptation and, in sinus rhythm, chronotropic reserve, are important compensatory mechanisms." 09/01/1989 - "Percent attainment of oxygen uptake in mitral stenosis differed significantly according to the NYHA class both at the anaerobic threshold and peak exercise. " 09/01/1989 - "[Anaerobic threshold and oxygen uptake in patients with mitral stenosis]."
6.	Propranolol (Inderal)FDA LinkGeneric 04/01/1994 - "We report the case of a young adult with mitral stenosis and pulmonary oedema who did not respond to conventional antifailure therapy, but improved with intravenous propranolol and later underwent successful balloon mitral valvotomy. " 12/01/1977 - "In this study, intravenous propranolol administered to patients with pure mitral stenosis in sinus rhythm resulted in significant reductions in mitral diastolic gradient (-7.1 mm. Hg +/- 1.6 SED), mean pulmonary wedge pressure (--6.9 mm. Hg +/- 1.2) and mean pulmonary artery pressures (--9.0 mm. Hg +/- 1.2). " 04/01/1994 - "Propranolol for pulmonary oedema in mitral stenosis." 09/01/1987 - "Propranolol did not improve objective or subjective exercise tolerance in patients with isolated mitral stenosis in sinus rhythm." 09/01/1987 - "Ten patients (aged 19-56) with moderate to severe isolated mitral stenosis were studied to determine whether propranolol increased their exercise tolerance. "
7.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 05/01/1988 - "A study of 17 patients with prevailing mitral stenosis and 10 patients with prevailing mitral insufficiency demonstrated a significant aspirin-induced improvement of blood rheologic characteristics in all patients that was accompanied with a heterogeneous shift of intracardiac hemodynamics and left-ventricular myocardial pumping activity. " 01/01/1994 - "A comparative study of coumadin and aspirin for primary cardioembolic stroke and thromboembolic preventions of chronic rheumatic mitral stenosis with atrial fibrillation." 06/01/1992 - "Anticoagulation with warfarin or aspirin reduces the risk of embolic events in patients with chronic atrial fibrillation and mitral valve stenosis or other underlying heart disease. " 01/01/1994 - "The comparative study of the efficacy of coumadin and aspirin in primary cardioembolic stroke prevention of chronic rheumatic heart disease (mitral stenosis) with atrial fibrillation was conducted at Siriraj Hospital, Mahidol University, Bangkok, Thailand. " 08/01/1992 - "In cases of AF without mitral stenosis, plasma levels of TAT and PTF were significantly lower in those patients receiving antithrombotic agents (aspirin or warfarin) than in those receiving no antithrombotic agents. "
8.	ivabradineIBA 04/01/2012 - "Ivabradine is more effective than atenolol for effort related symptoms in patients with mild-moderate mitral stenosis and normal sinus rhythm." 04/01/2012 - "We studied the comparative efficacy of heart rate control with ivabradine or atenolol and its effect on effort tolerance in patients with mild-moderate mitral stenosis in normal sinus rhythm. " 04/01/2012 - "Fifty patients with mild-moderate mitral stenosis in sinus rhythm were randomized to receive ivabradine or atenolol for 4 weeks each in an open-label, randomized, crossover design trial. " 06/01/2015 - "Effect of Ivabradine on Heart Rate and Duration of Exercise in Patients With Mild-to-Moderate Mitral Stenosis: A Randomized Comparison With Metoprolol." 04/01/2012 - "Effect of ivabradine vs atenolol on heart rate and effort tolerance in patients with mild to moderate mitral stenosis and normal sinus rhythm."
9.	Metoprolol (Lopressor)FDA LinkGeneric 11/01/1994 - "We conducted a placebo controlled randomised clinical trial to evaluate the effects of 6 months therapy with metoprolol on resting and exercise haemodynamics in 31 patients with isolated mitral stenosis in sinus rhythm. " 11/01/1994 - "Beneficial effects of long-term metoprolol therapy on cardiac haemodynamics in patients with mitral stenosis in sinus rhythm--a randomised clinical trial." 09/01/2002 - "Reliability and efficacy of metoprolol and diltiazem in patients having mild to moderate mitral stenosis with sinus rhythm." 06/01/2015 - "Effect of Ivabradine on Heart Rate and Duration of Exercise in Patients With Mild-to-Moderate Mitral Stenosis: A Randomized Comparison With Metoprolol." 09/01/2002 - "The authors evaluated the effects of beta blockers (metoprolol) and calcium channel blockers (diltiazem) in patients having mild to moderate mitral stenosis (MS) with sinus rhythm. "
10.	Isoproterenol (Isoprenaline)FDA LinkGeneric 06/01/1963 - "Differential hemodynamic effects of isoproterenol on mitral stenosis and left ventricular diseases." 07/01/1983 - "Compared with the response in patients with pure mitral valve stenosis, the response of cardiac adenylate cyclase activity to isoproterenol showed a marked decrease (-90%) in patients with combined mitral and aortic valve disease, corresponding to the severity of degree of insufficiency at both valves. " 06/01/1992 - "Hemodynamic effects of prostaglandin E1 and isoproterenol early after cardiac operations for mitral stenosis." 09/01/2007 - "Medical subject headings and keywords searched and cross-referenced with each other were: pulmonary hypertension, vasopressor agents, therapeutics, critical illness, intensive care, right ventricular failure, mitral stenosis, prostacyclin, nitric oxide, sildenafil, dopamine, dobutamine, phenylephrine, isoproterenol, and vasopressin. "

Therapies and Procedures

1.	Balloon Dilation 01/01/2012 - "Improved arterial stiffness in mitral stenosis after successful percutaneous balloon valvuloplasty." 05/01/1995 - "Percutaneous balloon valvuloplasty has been used with good results to treat rheumatic mitral stenosis. " 01/01/1992 - "Double transseptal, double-balloon valvuloplasty is an effective treatment for many forms of congenital mitral stenosis. " 09/01/1998 - "On follow-up they were in NYHA functional class I. Percutaneous mitral balloon valvotomy is a safe and effective procedure for selected pregnant patients with severe mitral stenosis. " 12/01/1992 - "Left atrial perforation occurred in one patient from group 1 and 2 patients from group II. In conclusion, mitral balloon valvuloplasty under transesophageal echocardiographic guidance alone is a safe and effective procedure in the treatment of mitral stenosis."
2.	Catheters 11/01/1990 - "The efficacy of balloon dilatation of the mitral valve by a bifoil (2 x 19 mm) or trefoil (3 x 15 mm) catheter (single catheter technique) was assessed in 53 patients (mean age 28) with mitral stenosis, most of whom were women. " 01/01/2006 - "Percutaneous balloon mitral valvuloplasty with Inoue balloon catheter is a safe and effective technique for treating rheumatic mitral stenosis with Wilkins score < 10, with minimal risk and complications and offers good life expectancy with absence of major cardiac events in > 90%. " 11/01/1990 - "Balloon dilatation of the mitral valve by the single catheter technique with the bifoil or trefoil catheters is an effective treatment for patients with mitral stenosis. " 05/01/2004 - "PTMC using the JOMIVA balloon catheter is a cost-effective and safe alternative to the Inoue balloon when treating symptomatic severe mitral stenosis. " 06/01/1994 - "We conclude the PMV using the Inoue balloon catheter is safe and effective in the treatment of severe mitral stenosis in children, with a low complication rate."
3.	Prostheses and Implants (Prosthesis) 02/01/2014 - "This study suggests that, in patients with rheumatic mitral stenosis and preserved left ventricular systolic function, the addition of papillary muscle repositioning to valve replacement with a mechanical prosthesis improves left ventricular dimensions, ejection fraction, and sphericity index at the 18-month follow-up with no substantial undesirable effect on the surgery-related factors. " 02/01/1997 - "We defined a hemodynamic profile of severity based on the data from 18 patients whose basal mitral valve areas was < 1.2 cm2 (group I), and compared them with the data from the 32 studies of mitral stenosis patients with an area > 1.1 cm2 (group II) and with the patients with mitral prostheses (group III). " 12/14/2014 - "ROCKET AF excluded patients with mitral stenosis or artificial valve prostheses. " 09/01/2013 - "Transcatheter mitral valve replacement using a balloon-expandable prosthesis in a patient with calcified native mitral valve stenosis." 08/06/2013 - "First in human transapical implantation of an inverted transcatheter aortic valve prosthesis to treat native mitral valve stenosis."
4.	Homologous Transplantation (Allograft) 08/01/2002 - "All three patients had mitral valve stenosis as the initial indication for surgery and had received a complete homograft. " 03/01/1994 - "Mitral valve replacement, using a cryopreserved mitral homograft, was performed in a 49-year-old patient with calcified mitral stenosis. " 02/01/1994 - "Mitral valve replacement using a cryopreserved mitral homograft was performed in a 49 year old patient with calcified mitral stenosis. " 01/01/1973 - "[Congenital mitral valve stenosis treated by an aortic valve homograft]." 07/01/1971 - "Congenital mitral stenosis treated by aortic homograft valve replacement. "
5.	Surgical Equipment 01/01/1981 - "Using digital trans-atrial commissurotomy, which is technically straightforward and involves little blood loss and no elaborate surgical equipment 18 patients with a lone mitral stenosis were symptomatically improved but three with mixed mitral stenosis and regurgitation died. "