PREDICTION OF HEMODYNAMIC CONDITIONS BY NONINVASIVE ARTERIAL TONOMETRY IN MITRAL-STENOSIS

To predict the hemodynamic conditions in patients with mitral stenosis (MS), continuous blood pressure responses were monitored noninvasivel y at the bedside by arterial tonometry during the Valsalva maneuver in 18 MS patients aged 54.2 +/- 9.1 (40 similar to 77) years (6 men, 12 women). Two indices during the Valsalva maneuver (blood pressure decli ne value at phase III (BPdec) and subsequent blood pressure overshoot value at phase IV (BPov)) were compared with hemodynamic data obtained by the cardiac catheterization method, and the correlations between t he changes in these parameters were examined. In these 18 patients, BP dec showed a significant negative correlation with the mean diastolic pressure gradient between the left atrium and left ventricle and showe d a significant negative correlation with pulmonary capillary wedge pr essure (PCWP) (r = -0.62, P < 0.01, r = -0.53, p < 0.05, respectively) . Mitral valve area (MVA) showed a significant positive correlation wi th BPdec (r = +0.63, p <0.01). Similarly, BPov showed a significant po sitive correlation with cardiac output (CO), cardiac index (CT) and MV A (r = +0.60, P < 0.01, r = +0.64, p < 0.01, r = +0.65, p < 0.01, resp ectively). Thus, continuous monitoring of blood pressure by arterial t onometry during the Valsalva maneuver is useful for predicting the hem odynamic conditions in patients with MS.