Valvular & structural heart disease
Long-Term Follow-Up in Severe Mitral Stenosis With Low Transmitral Diastolic Pressure Gradient: From MASTER Registry
Authors' conclusion
Patients with severe MS and low MDPG carried a greater risk of adverse events than those with high MDPG and had less frequent and delayed mitral valve intervention. Also, it is not necessarily indicative of milder hemodynamic encumbrance. Left atrial reservoir strain could help identify a subgroup associated with poor prognosis in patients with low MDPG.
Study context
- Population
- Patients with severe rheumatic mitral stenosis (MS) (mitral valve area ≤1.5 cm 2 )patients with severe MS
- Participants
- 1,248 patients
- Exposure
- Low vs high mean diastolic pressure gradient (MDPG)
- Low MDPGn = 322
- High MDPGn = 926reference
- Outcome
- composite of:
- All-cause mortality
- Stroke
- Follow-up
- Mean 6.8±5.9 years
Methodological detailsMulticenter, long-term
- Multicenter
- Long-term
Main finding
As reported in the abstract
low MDPG vs high MDPGHazard ratio (95% CI)P value
More events with low MDPG
1.56(1.15–2.12)
P = 0.004Multivariable model
1.42(1.02–1.97)
P = 0.038- Patients experienced major adverse events
- 194 (15.5%)
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Mean age
- 59±13 years
- Men
- 25%
- Atrial fibrillation
- 74%
- Patients with low MDPG were older and had a higher prevalence of atrial fibrillation
Poor outcome with decreased left atrial reservoir strain (subgroup of patients with low MDPG)
- Decreased left atrial reservoir strain, hazard ratio (95% CI, 1.25-8.31; P =0.016)
- 3.22
- Independently associated
Original publication
Long-Term Follow-Up in Severe Mitral Stenosis With Low Transmitral Diastolic Pressure Gradient: From MASTER Registry. Circ Cardiovasc Imaging. Published 16 July 2025. doi:10.
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