Pulmonary venous flow in pure mitral stenosis and sinus rhythm - Does pulmonary hypertension alter pulmonary venous flow velocity?

Jong Won Ha, Namsik Chung, Choong Won Goh, Kil Jin Jang, seokmin kang, Se Joong Rim, Yangsoo Jang, Won Heum Shim, Seung Yun Cho, Sung Soon Kim

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Pulmonary venous flow (PVF) is influenced by changes in left atrial (LA) pressure and function in various diseases. In mitral stenosis (MS), there is an alteration of LA hemodynamic due to the impaired ventricular filling caused by the stenotic valve and elevation of LA pressure. Although a variety of altered patterns of PVF have been described in MS, the potential influence of pulmonary hypertension, which is frequently associated with MS and has an adverse effect on the functional status and the prognosis of MS, on the PVF pattern is not clearly defined. The aim of this study is to determine the effects of pulmonary hypertension on PVF in patients with MS. Thirty-eight consecutive patients with pure MS and sinus rhythm (30 females, mean age 40 years old) underwent transthoracic and transesophageal echocardiography. Right heart and transseptal catheterization was also performed to measure pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), pulmonary capillary wedge pressure (PCWP), and left atrial pressure (LAP). The subjects were divided into two groups:group 1 (n = 25) included subjects with PASP < 50 mmHg, group 2 (n = 13) included subjects with PASP 50 mmHg. LA size, mitral valve area (MVA), mean mitral gradient (MG), LAP, PASP, PADP, PCWP, and the peak velocity of PV systolic (PVFS), diastolic (PVFD) and atrial reversal flow (PVFAr) were also measured and compared between the two groups. There was no significant difference in age, heart rate, MVA, and LA size between the two groups. LAP, PASP, PADP, PCWP, and MG were significantly higher in group 2. However, PVFS and PVFAr were significantly lower in group 2 (46.6 ± 15.8 vs 29.9 ± 12.8 cm/sec, P < 0.005;22.1 ± 6.8 vs 17.3 ± 5.9 cm/sec, P < 0.05). There was no significant difference of PVFD between the two groups. PVFS had negative correlation to LAP, MG, PASP, PADP, and PCWP. PVFAr had negative correlation with PASP, PADP, and PCWP. There was no significant correlation between PVFAr and MVA, LA size and LAP. In conclusion, in patients with pure MS and sinus rhythm, PVF, especially PVFAr, is influenced by the presence of pulmonary hypertension.

Original languageEnglish
Pages (from-to)129-135
Number of pages7
JournalEchocardiography
Volume20
Issue number2
DOIs
Publication statusPublished - 2003 Feb 1

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Mitral Valve Stenosis
Pulmonary Hypertension
Pulmonary Artery
Atrial Pressure
Blood Pressure
Lung
Pulmonary Wedge Pressure
Mitral Valve
Left Atrial Function
Transesophageal Echocardiography
Cardiac Catheterization
Echocardiography
Heart Rate
Hemodynamics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ha, Jong Won ; Chung, Namsik ; Goh, Choong Won ; Jang, Kil Jin ; kang, seokmin ; Rim, Se Joong ; Jang, Yangsoo ; Shim, Won Heum ; Cho, Seung Yun ; Kim, Sung Soon. / Pulmonary venous flow in pure mitral stenosis and sinus rhythm - Does pulmonary hypertension alter pulmonary venous flow velocity?. In: Echocardiography. 2003 ; Vol. 20, No. 2. pp. 129-135.
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title = "Pulmonary venous flow in pure mitral stenosis and sinus rhythm - Does pulmonary hypertension alter pulmonary venous flow velocity?",
abstract = "Pulmonary venous flow (PVF) is influenced by changes in left atrial (LA) pressure and function in various diseases. In mitral stenosis (MS), there is an alteration of LA hemodynamic due to the impaired ventricular filling caused by the stenotic valve and elevation of LA pressure. Although a variety of altered patterns of PVF have been described in MS, the potential influence of pulmonary hypertension, which is frequently associated with MS and has an adverse effect on the functional status and the prognosis of MS, on the PVF pattern is not clearly defined. The aim of this study is to determine the effects of pulmonary hypertension on PVF in patients with MS. Thirty-eight consecutive patients with pure MS and sinus rhythm (30 females, mean age 40 years old) underwent transthoracic and transesophageal echocardiography. Right heart and transseptal catheterization was also performed to measure pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), pulmonary capillary wedge pressure (PCWP), and left atrial pressure (LAP). The subjects were divided into two groups:group 1 (n = 25) included subjects with PASP < 50 mmHg, group 2 (n = 13) included subjects with PASP 50 mmHg. LA size, mitral valve area (MVA), mean mitral gradient (MG), LAP, PASP, PADP, PCWP, and the peak velocity of PV systolic (PVFS), diastolic (PVFD) and atrial reversal flow (PVFAr) were also measured and compared between the two groups. There was no significant difference in age, heart rate, MVA, and LA size between the two groups. LAP, PASP, PADP, PCWP, and MG were significantly higher in group 2. However, PVFS and PVFAr were significantly lower in group 2 (46.6 ± 15.8 vs 29.9 ± 12.8 cm/sec, P < 0.005;22.1 ± 6.8 vs 17.3 ± 5.9 cm/sec, P < 0.05). There was no significant difference of PVFD between the two groups. PVFS had negative correlation to LAP, MG, PASP, PADP, and PCWP. PVFAr had negative correlation with PASP, PADP, and PCWP. There was no significant correlation between PVFAr and MVA, LA size and LAP. In conclusion, in patients with pure MS and sinus rhythm, PVF, especially PVFAr, is influenced by the presence of pulmonary hypertension.",
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Pulmonary venous flow in pure mitral stenosis and sinus rhythm - Does pulmonary hypertension alter pulmonary venous flow velocity? / Ha, Jong Won; Chung, Namsik; Goh, Choong Won; Jang, Kil Jin; kang, seokmin; Rim, Se Joong; Jang, Yangsoo; Shim, Won Heum; Cho, Seung Yun; Kim, Sung Soon.

In: Echocardiography, Vol. 20, No. 2, 01.02.2003, p. 129-135.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pulmonary venous flow in pure mitral stenosis and sinus rhythm - Does pulmonary hypertension alter pulmonary venous flow velocity?

AU - Ha, Jong Won

AU - Chung, Namsik

AU - Goh, Choong Won

AU - Jang, Kil Jin

AU - kang, seokmin

AU - Rim, Se Joong

AU - Jang, Yangsoo

AU - Shim, Won Heum

AU - Cho, Seung Yun

AU - Kim, Sung Soon

PY - 2003/2/1

Y1 - 2003/2/1

N2 - Pulmonary venous flow (PVF) is influenced by changes in left atrial (LA) pressure and function in various diseases. In mitral stenosis (MS), there is an alteration of LA hemodynamic due to the impaired ventricular filling caused by the stenotic valve and elevation of LA pressure. Although a variety of altered patterns of PVF have been described in MS, the potential influence of pulmonary hypertension, which is frequently associated with MS and has an adverse effect on the functional status and the prognosis of MS, on the PVF pattern is not clearly defined. The aim of this study is to determine the effects of pulmonary hypertension on PVF in patients with MS. Thirty-eight consecutive patients with pure MS and sinus rhythm (30 females, mean age 40 years old) underwent transthoracic and transesophageal echocardiography. Right heart and transseptal catheterization was also performed to measure pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), pulmonary capillary wedge pressure (PCWP), and left atrial pressure (LAP). The subjects were divided into two groups:group 1 (n = 25) included subjects with PASP < 50 mmHg, group 2 (n = 13) included subjects with PASP 50 mmHg. LA size, mitral valve area (MVA), mean mitral gradient (MG), LAP, PASP, PADP, PCWP, and the peak velocity of PV systolic (PVFS), diastolic (PVFD) and atrial reversal flow (PVFAr) were also measured and compared between the two groups. There was no significant difference in age, heart rate, MVA, and LA size between the two groups. LAP, PASP, PADP, PCWP, and MG were significantly higher in group 2. However, PVFS and PVFAr were significantly lower in group 2 (46.6 ± 15.8 vs 29.9 ± 12.8 cm/sec, P < 0.005;22.1 ± 6.8 vs 17.3 ± 5.9 cm/sec, P < 0.05). There was no significant difference of PVFD between the two groups. PVFS had negative correlation to LAP, MG, PASP, PADP, and PCWP. PVFAr had negative correlation with PASP, PADP, and PCWP. There was no significant correlation between PVFAr and MVA, LA size and LAP. In conclusion, in patients with pure MS and sinus rhythm, PVF, especially PVFAr, is influenced by the presence of pulmonary hypertension.

AB - Pulmonary venous flow (PVF) is influenced by changes in left atrial (LA) pressure and function in various diseases. In mitral stenosis (MS), there is an alteration of LA hemodynamic due to the impaired ventricular filling caused by the stenotic valve and elevation of LA pressure. Although a variety of altered patterns of PVF have been described in MS, the potential influence of pulmonary hypertension, which is frequently associated with MS and has an adverse effect on the functional status and the prognosis of MS, on the PVF pattern is not clearly defined. The aim of this study is to determine the effects of pulmonary hypertension on PVF in patients with MS. Thirty-eight consecutive patients with pure MS and sinus rhythm (30 females, mean age 40 years old) underwent transthoracic and transesophageal echocardiography. Right heart and transseptal catheterization was also performed to measure pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), pulmonary capillary wedge pressure (PCWP), and left atrial pressure (LAP). The subjects were divided into two groups:group 1 (n = 25) included subjects with PASP < 50 mmHg, group 2 (n = 13) included subjects with PASP 50 mmHg. LA size, mitral valve area (MVA), mean mitral gradient (MG), LAP, PASP, PADP, PCWP, and the peak velocity of PV systolic (PVFS), diastolic (PVFD) and atrial reversal flow (PVFAr) were also measured and compared between the two groups. There was no significant difference in age, heart rate, MVA, and LA size between the two groups. LAP, PASP, PADP, PCWP, and MG were significantly higher in group 2. However, PVFS and PVFAr were significantly lower in group 2 (46.6 ± 15.8 vs 29.9 ± 12.8 cm/sec, P < 0.005;22.1 ± 6.8 vs 17.3 ± 5.9 cm/sec, P < 0.05). There was no significant difference of PVFD between the two groups. PVFS had negative correlation to LAP, MG, PASP, PADP, and PCWP. PVFAr had negative correlation with PASP, PADP, and PCWP. There was no significant correlation between PVFAr and MVA, LA size and LAP. In conclusion, in patients with pure MS and sinus rhythm, PVF, especially PVFAr, is influenced by the presence of pulmonary hypertension.

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