Correlation Between Left Atrial Volume Index and the Estimated Mean Pulmonary Artery Pressure in Patients with Mitral Regurgitation

Author : M. H. Cahyadi, R. Puspitoadhi, P.S. Putri, U. Bahrudin, M. A. Nugroho
Upload Date : 19-04-2018

Background: The common pathophysiological consequences of chronic mitral regurgitation (MR) are left atrial (LA) remodeling and pulmonary hypertension. The aim of this study was to investigate the correlation between LA volume index (LAVI) and the estimated mean pulmonary artery pressure (MPAP) in patients with MR.

Methods: Total of 89 patients (age 52.9±14.32 years old, 48.3% female) with mild to severe chronic MR. Severity of MR was assessed by using the echocardiographic parameters jet area and vena contracta. LAVI and the estimated MPAP were measured by area-length biplane method and the Mahan’s regression equation.

Results: Severe MR was found in 29 (32.6%) patients. Mean left ventricular ejection fraction (LVEF) was 45.14+20.37% with 49.4% of patients had a LVEF >50%. Median of LAVI was 40.60 (16.00151.20) ml/m2. LAVI was 45.71 and 35.48 ml/mm2 among those with high MPAP (>25 mmHg) and normal MPAP, respectively (p=0.002). LAVI had a significant correlation to the estimated MPAP (r=0.259, p=0.016). Receiver operating characteristic analysis showed that area under curve for LAVI was 0.68 for the estimated MPAP. Patients with LAVI >41.80 mm2 were likely to have pulmonary hypertension (OR = 3.60).

Conclusions: In patients with mitral regurgitation, left atrial volume index was correlated with the estimated mean pulmonary artery pressure; and LAVI correlates with a higher probability of pulmonary hypertension.

KEYWORDS : Left atrial volume index, mitral regurgitation, mean pulmonary artery pressure.

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