Effects of left atrial compliance on left atrial pressure in pure mitral stenosis

Young Guk Ko, Jong Won Ha, Namsik Chung, Won Heum Shim, Seok Min Kang, Se Joong Rim, Yangsoo Jang, Seung Yun Cho, Sung Soon Kim

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

In mitral stenosis (MS), left atrial (LA) pressure is commonly elevated because of increased LA afterload. There is a wide spectrum of LA pressure in patients with MS, however, despite a similar mitral valve orifice area. LA compliance is an important determinant of both cardiovascular performance and pathological physiology. Few data are available, however, regarding the effects of LA compliance on LA pressure. We hypothesized that LA pressure may be higher in patients with decreased LA compliance. We analyzed the right heart and transseptal catheterization data in 47 patients (41 female, mean age 40 ± 10 years) with pure MS and sinus rhythm. The magnitude of LA a and v waves was measured from transseptal catheterization. Fick's method was used to determine cardiac output. LA compliance was calculated by dividing the systolic rise in LA pressure (ΔPLA = PLA(V) - PLA(x)) into the stroke volume. LA size, mitral valve area (MVA), mean diastolic pressure gradient (MG), left ventricular (LV) end-diastolic and end-systolic dimensions were obtained by using two-dimensional and Doppler echocardiography. Multiple regression analysis was performed to identify independent factors determining LA pressure. The mean MVA was 0.95 ± 0.22 cm2. MG and LA dimension were 11.2 ± 5.2 mm Hg and 50.6 ± 5.2 mm, respectively. The mean LA pressure and cardiac output obtained by cardiac catheterization were 23.4 ± 8.4 mm Hg and 4.3 ± 1.5 L/min, respectively. The calculated LA compliance was 4.9 ± 2.8 cm3/mm Hg. Univariate analysis showed that factors associated with increased LA pressure were smaller MVA (r = -0.33, P < 0.05), higher MG (r = 0.69, P < 0.01) and lower LA compliance (r = -0.55, P < 0.01); among them, MG (beta coefficient 0.59, SE 0.19, P < 0.01) and LA compliance (beta coefficient -0.26, standard error 0.34, P < 0.05) were the strongest predictors of LA pressure. In conclusion, LA compliance, along with MG that reflects the severity of MS, is an important contributing factor determining LA pressure in patients with pure MS and sinus rhythm.

Original languageEnglish
Pages (from-to)328-333
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume52
Issue number3
DOIs
Publication statusPublished - 2001 Mar 13

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Atrial Pressure
Mitral Valve Stenosis
Compliance
Mitral Valve
Cardiac Catheterization
Cardiac Output
Doppler Echocardiography
Catheterization
Stroke Volume
Statistical Factor Analysis
Regression Analysis
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ko, Young Guk ; Ha, Jong Won ; Chung, Namsik ; Shim, Won Heum ; Kang, Seok Min ; Rim, Se Joong ; Jang, Yangsoo ; Cho, Seung Yun ; Kim, Sung Soon. / Effects of left atrial compliance on left atrial pressure in pure mitral stenosis. In: Catheterization and Cardiovascular Interventions. 2001 ; Vol. 52, No. 3. pp. 328-333.
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abstract = "In mitral stenosis (MS), left atrial (LA) pressure is commonly elevated because of increased LA afterload. There is a wide spectrum of LA pressure in patients with MS, however, despite a similar mitral valve orifice area. LA compliance is an important determinant of both cardiovascular performance and pathological physiology. Few data are available, however, regarding the effects of LA compliance on LA pressure. We hypothesized that LA pressure may be higher in patients with decreased LA compliance. We analyzed the right heart and transseptal catheterization data in 47 patients (41 female, mean age 40 ± 10 years) with pure MS and sinus rhythm. The magnitude of LA a and v waves was measured from transseptal catheterization. Fick's method was used to determine cardiac output. LA compliance was calculated by dividing the systolic rise in LA pressure (ΔPLA = PLA(V) - PLA(x)) into the stroke volume. LA size, mitral valve area (MVA), mean diastolic pressure gradient (MG), left ventricular (LV) end-diastolic and end-systolic dimensions were obtained by using two-dimensional and Doppler echocardiography. Multiple regression analysis was performed to identify independent factors determining LA pressure. The mean MVA was 0.95 ± 0.22 cm2. MG and LA dimension were 11.2 ± 5.2 mm Hg and 50.6 ± 5.2 mm, respectively. The mean LA pressure and cardiac output obtained by cardiac catheterization were 23.4 ± 8.4 mm Hg and 4.3 ± 1.5 L/min, respectively. The calculated LA compliance was 4.9 ± 2.8 cm3/mm Hg. Univariate analysis showed that factors associated with increased LA pressure were smaller MVA (r = -0.33, P < 0.05), higher MG (r = 0.69, P < 0.01) and lower LA compliance (r = -0.55, P < 0.01); among them, MG (beta coefficient 0.59, SE 0.19, P < 0.01) and LA compliance (beta coefficient -0.26, standard error 0.34, P < 0.05) were the strongest predictors of LA pressure. In conclusion, LA compliance, along with MG that reflects the severity of MS, is an important contributing factor determining LA pressure in patients with pure MS and sinus rhythm.",
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Effects of left atrial compliance on left atrial pressure in pure mitral stenosis. / Ko, Young Guk; Ha, Jong Won; Chung, Namsik; Shim, Won Heum; Kang, Seok Min; Rim, Se Joong; Jang, Yangsoo; Cho, Seung Yun; Kim, Sung Soon.

In: Catheterization and Cardiovascular Interventions, Vol. 52, No. 3, 13.03.2001, p. 328-333.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of left atrial compliance on left atrial pressure in pure mitral stenosis

AU - Ko, Young Guk

AU - Ha, Jong Won

AU - Chung, Namsik

AU - Shim, Won Heum

AU - Kang, Seok Min

AU - Rim, Se Joong

AU - Jang, Yangsoo

AU - Cho, Seung Yun

AU - Kim, Sung Soon

PY - 2001/3/13

Y1 - 2001/3/13

N2 - In mitral stenosis (MS), left atrial (LA) pressure is commonly elevated because of increased LA afterload. There is a wide spectrum of LA pressure in patients with MS, however, despite a similar mitral valve orifice area. LA compliance is an important determinant of both cardiovascular performance and pathological physiology. Few data are available, however, regarding the effects of LA compliance on LA pressure. We hypothesized that LA pressure may be higher in patients with decreased LA compliance. We analyzed the right heart and transseptal catheterization data in 47 patients (41 female, mean age 40 ± 10 years) with pure MS and sinus rhythm. The magnitude of LA a and v waves was measured from transseptal catheterization. Fick's method was used to determine cardiac output. LA compliance was calculated by dividing the systolic rise in LA pressure (ΔPLA = PLA(V) - PLA(x)) into the stroke volume. LA size, mitral valve area (MVA), mean diastolic pressure gradient (MG), left ventricular (LV) end-diastolic and end-systolic dimensions were obtained by using two-dimensional and Doppler echocardiography. Multiple regression analysis was performed to identify independent factors determining LA pressure. The mean MVA was 0.95 ± 0.22 cm2. MG and LA dimension were 11.2 ± 5.2 mm Hg and 50.6 ± 5.2 mm, respectively. The mean LA pressure and cardiac output obtained by cardiac catheterization were 23.4 ± 8.4 mm Hg and 4.3 ± 1.5 L/min, respectively. The calculated LA compliance was 4.9 ± 2.8 cm3/mm Hg. Univariate analysis showed that factors associated with increased LA pressure were smaller MVA (r = -0.33, P < 0.05), higher MG (r = 0.69, P < 0.01) and lower LA compliance (r = -0.55, P < 0.01); among them, MG (beta coefficient 0.59, SE 0.19, P < 0.01) and LA compliance (beta coefficient -0.26, standard error 0.34, P < 0.05) were the strongest predictors of LA pressure. In conclusion, LA compliance, along with MG that reflects the severity of MS, is an important contributing factor determining LA pressure in patients with pure MS and sinus rhythm.

AB - In mitral stenosis (MS), left atrial (LA) pressure is commonly elevated because of increased LA afterload. There is a wide spectrum of LA pressure in patients with MS, however, despite a similar mitral valve orifice area. LA compliance is an important determinant of both cardiovascular performance and pathological physiology. Few data are available, however, regarding the effects of LA compliance on LA pressure. We hypothesized that LA pressure may be higher in patients with decreased LA compliance. We analyzed the right heart and transseptal catheterization data in 47 patients (41 female, mean age 40 ± 10 years) with pure MS and sinus rhythm. The magnitude of LA a and v waves was measured from transseptal catheterization. Fick's method was used to determine cardiac output. LA compliance was calculated by dividing the systolic rise in LA pressure (ΔPLA = PLA(V) - PLA(x)) into the stroke volume. LA size, mitral valve area (MVA), mean diastolic pressure gradient (MG), left ventricular (LV) end-diastolic and end-systolic dimensions were obtained by using two-dimensional and Doppler echocardiography. Multiple regression analysis was performed to identify independent factors determining LA pressure. The mean MVA was 0.95 ± 0.22 cm2. MG and LA dimension were 11.2 ± 5.2 mm Hg and 50.6 ± 5.2 mm, respectively. The mean LA pressure and cardiac output obtained by cardiac catheterization were 23.4 ± 8.4 mm Hg and 4.3 ± 1.5 L/min, respectively. The calculated LA compliance was 4.9 ± 2.8 cm3/mm Hg. Univariate analysis showed that factors associated with increased LA pressure were smaller MVA (r = -0.33, P < 0.05), higher MG (r = 0.69, P < 0.01) and lower LA compliance (r = -0.55, P < 0.01); among them, MG (beta coefficient 0.59, SE 0.19, P < 0.01) and LA compliance (beta coefficient -0.26, standard error 0.34, P < 0.05) were the strongest predictors of LA pressure. In conclusion, LA compliance, along with MG that reflects the severity of MS, is an important contributing factor determining LA pressure in patients with pure MS and sinus rhythm.

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