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Effect 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 
 Catheterization and Cardiovascular Interventions, Vol.52(3) : 328-333, 2001 
Journal Title
 Catheterization and Cardiovascular Interventions 
Issue Date
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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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk)
임세중(Rim, Se Joong)
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
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