Decrease in Mean Platelet Volume after percutaneous transvenous mitral commissurotomy in patients with Rheumatic Mitral Stenosis

Abstract

Introduction: Rheumatic mitral stenosis (RMS) is associated with increased thromboembolic events, especially in the presence of concomitant atrial fibrillation. Mean platelet volume (MPV) is the marker of platelet activity as larger platelets are hemostatically active and have more propensity of thrombosis. It has also been reported that percutaneous transvenous mitral commissurotomy (PTMC) attenuates platelet activity. We aimed to investigate whether PTMC decreases MPV in patients with RMS.

Methods: In the present study, MPV was measured in 39 patients with RMS in sinus rhythm just before and one month after PTMC. Thirty four, sex and age-matched, apparently healthy controls were used for comparison. Mitral valve area (MVA), mean diastolic gradient across mitral valve (MDG) and pulmonary artery systolic pressure (PASP) were measured using transthoracic echocardiography and mean left atrial (LA) pressure measured during the procedure.

Results: As compared to apparently healthy controls, patients with RMS had higher MPV (11.51±1.46 v. 9.6+0.75l, p<0.001). All patients with RMS underwent successful PTMC. One month after the procedure, LA diameter, MVA, MDG, PASP and LA pressures were reduced significantly (p< 0.001). The final mean platelet volume measured in patients with RMS undergoing PTMC measured after one month also had significant reduction when compared with the initial mean MPV (11.51±1.46 vs 9.55 1.11 0.001).

Conclusions: As compared to apparently healthy controls, patients with RMS have higher MPV reflecting increased platelet activity, and PTMC is associated with a significant decrease in MPV one month after the procedure.