Invasive Hemodynamic Characteristics in Patients With Mitral Annular Calcification Related Mitral Stenosis and Chest Radiation

Quantification of invasive hemodynamics and mitral annular calcification-related mitral stenosis remains under-explored in patients exposed to chest radiation. We sought to explore invasive hemodynamic parameters via transseptal catheterization in patients with and without chest radiation who had a diagnosis of mitral annular calcification-related mitral stenosis. After excluding patients with more than moderate mitral regurgitation, we found that there was no difference in mitral valve area on hemodynamic testing in patients with and without radiation with an elevated baseline transmitral gradient on transthoracic echocardiography in the setting of mitral annular calcification-related mitral stenosis. There was a higher transmitral gradient and left atrial pressure in patients with prior radiation consistent with left atrial noncompliance, suggesting that treating mitral valve stenosis may not relieve symptoms in this cohort of patients.