Correlation between Left Atrial Volume Index and Pulmonary Hypertension in Patient with Moderate to Severe Aortic Stenosis
Apisit Leedumrongwattanakul, MD¹ , ², Jarugit Sangmaneepimai, BSc¹, Kanjana Intasang, BSc¹, Pimporn Herwutthiwong, BSc¹
Affiliation : ¹ Cardiology Unit, Department of Medicine, Pranangklao Hospital, Nonthaburi, Thailand ² Faculty of Medicine, Siam University, Bangkok, Thailand
Background: Left atrial dilatation is a response to pressure overload in aortic stenosis (AS).
Objective: To study the correlation between left atrium volume index (LAVI) and the pulmonary hypertension in patients with moderate to severe AS.
Materials and Methods: The authors retrospectively studied patients with moderate to severe AS (either one or all echocardiographic criteria of aortic valve area [AVA]) smaller than 1.5 cm², AV Vmax of more than 3 m/s, AV mean PG of more than 30 mmHg who underwent transthoracic echocardiography at Pranangklao Hospital between January 2015 and December 2019.
Results: One hundred thirty-four patients (age 72.31±12.32 years, 46.3% male) were enrolled. In pulmonary hypertension group, proportion of atrial fibrillation (75%) were significantly higher Sinus Rhythm (26.3%). Right ventricular systolic pressure (RVSP) tended to increase when LAVI increased (r=0.695, p<0.001). The mean RVSP in four groups of LAVI (less than 35 ml/m², 35 to 41 ml/m², 42 to 48 ml/m², and more than 48 ml/m²) were 35.11±8.97, 38.22±11.71, 39.0±8.57, and 60.05±31 mmHg, respectively. RVSP in patients with LAVI of more than 48 ml/m² was significantly higher than those of the other group (p<0.001). LAVI in patients with RVSP of less than 50 and more than 50 mmHg were 35.13±6.86 and 65.22±11.55 ml/m², respectively (p<0.001).
Conclusion: Moderate to severe AS, RVSP increase when LAVI increases.
Received 23 Mar 2020 | Revised 29 May 2020 | Accepted 2 Jun 2020
doi.org/10.35755/jmedassocthai.2020.08.11229
Keywords : Echocardiography, Left atrium volume index, Aortic stenosis, Pulmonary hypertension
