Relation of left atrial dysfunction to pulmonary artery hypertension in patients with aortic stenosis and left ventricular systolic dysfunction

The American Journal of Cardiology
Roberto M SaraivaTakahiro Shiota

Abstract

Pulmonary artery hypertension (PAH) increases mortality in patients with severe aortic stenosis. We hypothesized that left atrial (LA) dysfunction would be related to PAH in patients with severe aortic stenosis complicated by left ventricular (LV) systolic dysfunction. The data from 70 patients with severe aortic stenosis and LV systolic dysfunction were analyzed. From the transmitral flow, the peak early (E) and late (A) diastolic velocities were obtained. From the pulmonary vein flow, the peak S-wave, D-wave, and reversed atrial wave velocities were determined. The right ventricular systolic pressure was measured in 50 patients and averaged 38 +/- 13 mm Hg. Patients with PAH (n = 19) presented with greater LV diameters, E/A ratio, E-wave velocity, LV mass index, reversed atrial wave velocity, and LA volume (p <0.05) and lower S/D ratio and total and active LA emptying fractions (p <0.05). Simple linear regression analysis revealed that the LA volumes and total and active LA emptying fractions displayed the strongest correlations with the right ventricular systolic pressure. Multiple regression analysis revealed that the minimum LA volume (r = 0.61, p = 0.0001) independently correlated with the right ventricular systolic press...Continue Reading

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Citations

Jul 19, 2012·Journal of Veterinary Internal Medicine·S M JohnsJ M Gay
Sep 27, 2012·Progress in Cardiovascular Diseases·Sean R WilsonEvelyn M Horn
May 30, 2013·International Journal of Cardiology·Antonio MiceliMattia Glauber
Nov 5, 2014·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Dimitry SchewelUlrich Schäfer
Dec 22, 2020·Trends in Cardiovascular Medicine·Micha T MaederHans Rickli

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