Publication: Left atrial volume index as an independent determinant of pulmonary hypertension in patients with chronic organic mitral regurgitation
Issued Date
2016
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Cardiovascular Disorders. Vol. 16, (2016), 141
Suggested Citation
Nithima Ratanasit, Khemajira Karaketklang, Rungroj Krittayaphong Left atrial volume index as an independent determinant of pulmonary hypertension in patients with chronic organic mitral regurgitation. BMC Cardiovascular Disorders. Vol. 16, (2016), 141. doi:10.1186/s12872-016-0306-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2683
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Title
Left atrial volume index as an independent determinant of pulmonary hypertension in patients with chronic organic mitral regurgitation
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Abstract
Background: The common pathophysiological consequences of chronic mitral regurgitation (MR) are left atrial
(LA) remodeling/dilatation and pulmonary hypertension (PH). We aimed to study the association between LA
volume (LAV) and PH in patients with chronic organic MR.
Methods: We prospectively studied 154 patients (age 55.0 ± 16.4 years, 39.6 % female) with isolated moderate to
severe chronic organic MR. Severity of MR was assessed using proximal isovelocity surface area method. LAV was
assessed using the area-length biplane method. PH was defined as pulmonary artery systolic pressure > 50 mmHg.
Results: Ruptured chordae and flail leaflets were the most common etiology of MR (53.2 %). Severe MR
(effective regurgitant orifice area (EROA) > 40 mm2) was described in 123 (79.9 %) patients. Dyspnea, history
of heart failure and atrial fibrillation was reported in 37.7 %, 20.1 % and 29.4 % of patients, respectively.
Left ventricular (LV) ejection fraction was 68.1 ± 5.9 %. LAV index and EROA were 67.1 (24.7–391.3) ml/m2
and 60.3 (10.5–250.9) mm2, respectively. Age, presence of atrial fibrillation, EROA, LV end-systolic and end-diastolic
volume, LV mass index, LAV index and tricuspid annular plane systolic excursion were all factors univariately associated
with PH. In multiple logistic regression analysis, age (OR = 1.03, 95 % CI: 1.001-1.06, p = 0.04), EROA (OR = 1.02, 95 % CI:
1.003-1.03, p = 0.017) and LAV index (OR = 1.01, 95 % CI: 1.002-1.02, p = 0.021) were independently associated with PH.
Conclusions: In patients with chronic organic MR, a significant association exists between LAV index and PH. Age, the
severity of MR as assessed by EROA, and LAV index are the independent determinants of PH.