Is the left atrial v wave the determinant of peak pulmonary artery pressure in patients with pure mitral stenosis?

Jong Won Ha, Namsik Chung, Yangsoo Jang, Woong Chul Kang, seokmin kang, Se Joong Rim, Won Heum Shim, Seung Yun Cho, Sung Soon Kim

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

A large left atrial (LA) v wave can be observed in patients with pure mitral stenosis (MS) because of decreased LA compliance. Few data are available regarding the relation between the magnitude of the LA v wave and pulmonary artery pressure in MS. We hypothesized that pulmonary artery pressure may be higher in patients with decreased LA compliance and thus a large v wave. We analyzed the right-sided cardiac and transseptal catheterization data in 113 patients (16 men and 97 women, mean age 39 years) with pure rheumatic MS in sinus rhythm. Peak systolic, diastolic, and mean pulmonary artery pressures were measured with right-sided cardiac catheterization. The magnitude of LA a and v waves were measured through transseptal catheterization. Two-dimensional and Doppler echocardiography were also performed to measure LA size, mitral valve area, mean mitral gradient, and valvular regurgitation. Multiple regression analysis was performed to identify the most important factor in the determination of pulmonary artery pressure. A large v wave, defined if peak v wave height exceeded the mean LA pressure by ≥10 mm Hg, was observed in 43 of 113 patients (38%). Increased pulmonary artery systolic pressure (≥50 mm Hg) was observed in 38 patients (34%). Univariate analysis showed that the factors associated with increased pulmonary artery systolic pressure were smaller mitral valve area, higher mean mitral gradient, higher mean LA pressure, and higher LA v wave; among them, LA v wave (p <0.001) and mean mitral gradient (p <0.001) were significant independent factors for pulmonary artery systolic pressure in multivariate analysis. In conclusion, in patients with pure MS and sinus rhythm, the magnitude of the LA v wave is strongly associated with pulmonary artery pressure. This finding may suggest that LA compliance is a major contributing factor determining pulmonary artery pressure in pure MS.

Original languageEnglish
Pages (from-to)986-991
Number of pages6
JournalAmerican Journal of Cardiology
Volume85
Issue number8
DOIs
Publication statusPublished - 2000 Apr 15

Fingerprint

Mitral Valve Stenosis
Pulmonary Artery
Pressure
Compliance
Atrial Pressure
Cardiac Catheterization
Blood Pressure
Mitral Valve
Doppler Echocardiography
Catheterization
Statistical Factor Analysis
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Ha, Jong Won ; Chung, Namsik ; Jang, Yangsoo ; Kang, Woong Chul ; kang, seokmin ; Rim, Se Joong ; Shim, Won Heum ; Cho, Seung Yun ; Kim, Sung Soon. / Is the left atrial v wave the determinant of peak pulmonary artery pressure in patients with pure mitral stenosis?. In: American Journal of Cardiology. 2000 ; Vol. 85, No. 8. pp. 986-991.
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title = "Is the left atrial v wave the determinant of peak pulmonary artery pressure in patients with pure mitral stenosis?",
abstract = "A large left atrial (LA) v wave can be observed in patients with pure mitral stenosis (MS) because of decreased LA compliance. Few data are available regarding the relation between the magnitude of the LA v wave and pulmonary artery pressure in MS. We hypothesized that pulmonary artery pressure may be higher in patients with decreased LA compliance and thus a large v wave. We analyzed the right-sided cardiac and transseptal catheterization data in 113 patients (16 men and 97 women, mean age 39 years) with pure rheumatic MS in sinus rhythm. Peak systolic, diastolic, and mean pulmonary artery pressures were measured with right-sided cardiac catheterization. The magnitude of LA a and v waves were measured through transseptal catheterization. Two-dimensional and Doppler echocardiography were also performed to measure LA size, mitral valve area, mean mitral gradient, and valvular regurgitation. Multiple regression analysis was performed to identify the most important factor in the determination of pulmonary artery pressure. A large v wave, defined if peak v wave height exceeded the mean LA pressure by ≥10 mm Hg, was observed in 43 of 113 patients (38{\%}). Increased pulmonary artery systolic pressure (≥50 mm Hg) was observed in 38 patients (34{\%}). Univariate analysis showed that the factors associated with increased pulmonary artery systolic pressure were smaller mitral valve area, higher mean mitral gradient, higher mean LA pressure, and higher LA v wave; among them, LA v wave (p <0.001) and mean mitral gradient (p <0.001) were significant independent factors for pulmonary artery systolic pressure in multivariate analysis. In conclusion, in patients with pure MS and sinus rhythm, the magnitude of the LA v wave is strongly associated with pulmonary artery pressure. This finding may suggest that LA compliance is a major contributing factor determining pulmonary artery pressure in pure MS.",
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Is the left atrial v wave the determinant of peak pulmonary artery pressure in patients with pure mitral stenosis? / Ha, Jong Won; Chung, Namsik; Jang, Yangsoo; Kang, Woong Chul; kang, seokmin; Rim, Se Joong; Shim, Won Heum; Cho, Seung Yun; Kim, Sung Soon.

In: American Journal of Cardiology, Vol. 85, No. 8, 15.04.2000, p. 986-991.

Research output: Contribution to journalArticle

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T1 - Is the left atrial v wave the determinant of peak pulmonary artery pressure in patients with pure mitral stenosis?

AU - Ha, Jong Won

AU - Chung, Namsik

AU - Jang, Yangsoo

AU - Kang, Woong Chul

AU - kang, seokmin

AU - Rim, Se Joong

AU - Shim, Won Heum

AU - Cho, Seung Yun

AU - Kim, Sung Soon

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N2 - A large left atrial (LA) v wave can be observed in patients with pure mitral stenosis (MS) because of decreased LA compliance. Few data are available regarding the relation between the magnitude of the LA v wave and pulmonary artery pressure in MS. We hypothesized that pulmonary artery pressure may be higher in patients with decreased LA compliance and thus a large v wave. We analyzed the right-sided cardiac and transseptal catheterization data in 113 patients (16 men and 97 women, mean age 39 years) with pure rheumatic MS in sinus rhythm. Peak systolic, diastolic, and mean pulmonary artery pressures were measured with right-sided cardiac catheterization. The magnitude of LA a and v waves were measured through transseptal catheterization. Two-dimensional and Doppler echocardiography were also performed to measure LA size, mitral valve area, mean mitral gradient, and valvular regurgitation. Multiple regression analysis was performed to identify the most important factor in the determination of pulmonary artery pressure. A large v wave, defined if peak v wave height exceeded the mean LA pressure by ≥10 mm Hg, was observed in 43 of 113 patients (38%). Increased pulmonary artery systolic pressure (≥50 mm Hg) was observed in 38 patients (34%). Univariate analysis showed that the factors associated with increased pulmonary artery systolic pressure were smaller mitral valve area, higher mean mitral gradient, higher mean LA pressure, and higher LA v wave; among them, LA v wave (p <0.001) and mean mitral gradient (p <0.001) were significant independent factors for pulmonary artery systolic pressure in multivariate analysis. In conclusion, in patients with pure MS and sinus rhythm, the magnitude of the LA v wave is strongly associated with pulmonary artery pressure. This finding may suggest that LA compliance is a major contributing factor determining pulmonary artery pressure in pure MS.

AB - A large left atrial (LA) v wave can be observed in patients with pure mitral stenosis (MS) because of decreased LA compliance. Few data are available regarding the relation between the magnitude of the LA v wave and pulmonary artery pressure in MS. We hypothesized that pulmonary artery pressure may be higher in patients with decreased LA compliance and thus a large v wave. We analyzed the right-sided cardiac and transseptal catheterization data in 113 patients (16 men and 97 women, mean age 39 years) with pure rheumatic MS in sinus rhythm. Peak systolic, diastolic, and mean pulmonary artery pressures were measured with right-sided cardiac catheterization. The magnitude of LA a and v waves were measured through transseptal catheterization. Two-dimensional and Doppler echocardiography were also performed to measure LA size, mitral valve area, mean mitral gradient, and valvular regurgitation. Multiple regression analysis was performed to identify the most important factor in the determination of pulmonary artery pressure. A large v wave, defined if peak v wave height exceeded the mean LA pressure by ≥10 mm Hg, was observed in 43 of 113 patients (38%). Increased pulmonary artery systolic pressure (≥50 mm Hg) was observed in 38 patients (34%). Univariate analysis showed that the factors associated with increased pulmonary artery systolic pressure were smaller mitral valve area, higher mean mitral gradient, higher mean LA pressure, and higher LA v wave; among them, LA v wave (p <0.001) and mean mitral gradient (p <0.001) were significant independent factors for pulmonary artery systolic pressure in multivariate analysis. In conclusion, in patients with pure MS and sinus rhythm, the magnitude of the LA v wave is strongly associated with pulmonary artery pressure. This finding may suggest that LA compliance is a major contributing factor determining pulmonary artery pressure in pure MS.

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