دورية أكاديمية
Left atrial dysfunction as a determinant of pulmonary hypertension in patients with severe aortic stenosis and preserved left ventricular ejection fraction.
العنوان: | Left atrial dysfunction as a determinant of pulmonary hypertension in patients with severe aortic stenosis and preserved left ventricular ejection fraction. |
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المؤلفون: | Calin A; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Mateescu AD; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Rosca M; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Beladan CC; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Enache R; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Botezatu S; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania., Cosei I; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Calin C; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Simion M; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Ginghina C; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania., Popescu AC; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania. andreea.catarina.popescu@gmail.com.; Cardiology Department, Elias Hospital, Bd. Marasti nr.17, Sector 1, 011461, Bucharest, Romania. andreea.catarina.popescu@gmail.com., Popescu BA; University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Bucharest, Romania.; Emergency Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania. |
المصدر: | The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2017 Dec; Vol. 33 (12), pp. 1939-1947. Date of Electronic Publication: 2017 Jul 15. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 100969716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1875-8312 (Electronic) Linking ISSN: 15695794 NLM ISO Abbreviation: Int J Cardiovasc Imaging Subsets: MEDLINE |
أسماء مطبوعة: | Publication: [New York] : Springer Original Publication: Boston : Kluwer Academic Publishers, c2001- |
مواضيع طبية MeSH: | Atrial Function, Left* , Stroke Volume* , Ventricular Function, Left*, Aortic Valve/*physiopathology , Aortic Valve Stenosis/*complications , Hypertension, Pulmonary/*etiology, Aged ; Aortic Valve/diagnostic imaging ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/physiopathology ; Echocardiography, Doppler ; Female ; Humans ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/physiopathology ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index |
مستخلص: | In patients with severe aortic stenosis (AS), the presence of pulmonary hypertension (PH) has been linked to a poor prognosis. We aimed to assess the main determinants of PH in patients with severe AS and preserved left ventricular ejection fraction (LVEF). We prospectively enrolled 108 consecutive patients with isolated severe AS (indexed aortic valve area <0.6 cm 2 /m 2 ) and LVEF >50%, in sinus rhythm. Left atrial (LA) function was assessed using longitudinal deformation parameters (by speckle tracking echocardiography). PH (defined as systolic pulmonary artery pressure >40 mmHg) was present in 20 patients. Patients with severe AS and PH were older (p = 0.05), had higher BNP values (p = 0.05) and a greater degree of LV diastolic dysfunction: higher E/e' and E/A ratios and lower EDT values (p < 0.03 for all) compared to patients without PH. There were no differences between groups regarding AS severity and LV systolic function parameters. Patients with PH had a more impaired LA function: lower septal and lateral late diastolic peak velocity a' (p < 0.001 and p = 0.04 respectively) and lower LA peak longitudinal strain and strain rate parameters (p ≤ 0.005 for all). In multivariable analysis, LA late diastolic longitudinal strain rate was the only independent correlate of PH in our patients (p = 0.04). Patients with isolated severe AS, preserved LVEF and PH had larger LA volumes, a more impaired LA function, and higher LV filling pressures compared to those without PH. LA booster pump function, reflected by late diastolic longitudinal strain rate, emerged as an independent correlate of PH in these patients. |
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معلومات مُعتمدة: | PN-II-IDPCE-2012-4-0560 Ministerul Educaţiei Naţionale (RO), CNCS - UEFISCDI |
فهرسة مساهمة: | Keywords: Aortic stenosis; Left atrial dysfunction; Preserved left ventricular ejection fraction; Pulmonary hypertension |
تواريخ الأحداث: | Date Created: 20170717 Date Completed: 20180105 Latest Revision: 20181113 |
رمز التحديث: | 20221213 |
DOI: | 10.1007/s10554-017-1211-2 |
PMID: | 28712069 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1875-8312 |
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DOI: | 10.1007/s10554-017-1211-2 |