3 research outputs found
Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension.
BackgroundImpaired left ventricular diastolic filling is common in chronic thromboembolic pulmonary hypertension (CTEPH), and recent studies support left ventricular underfilling as a cause. To investigate this further, we assessed left atrial volume index (LAVI) in patients with CTEPH before and after pulmonary thromboendarterectomy (PTE).MethodsForty-eight consecutive CTEPH patients had pre- & post-PTE echocardiograms and right heart catheterizations. Parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), cardiac index, LAVI, & mitral E/A ratio. Echocardiograms were performed 6βΒ±β3Β days pre-PTE and 10βΒ±β4Β days post-PTE. Regression analyses compared pre- and post-PTE LAVI with other parameters.ResultsPre-op LAVI (mean 19.0βΒ±β7Β mL/m2) correlated significantly with pre-op PVR (Rβ=β-0.45, pβ=β0.001), mPAP (Rβ=β-0.28, pβ=β0.05) and cardiac index (Rβ=β0.38, pβ=β0.006). Post-PTE, LAVI increased by 18% to 22.4βΒ±β7Β mL/m2 (pβ=β0.003). This change correlated with change in PVR (765 to 311 dyne-s/cm5, pβ=β0.01), cardiac index (2.6 to 3.2Β L/min/m2, pβ=β0.02), and E/A (.95 to 1.44, pβ=β0.002).ConclusionIn CTEPH, smaller LAVI is associated with lower cardiac output, higher mPAP, and higher PVR. LAVI increases by ~20% after PTE, and this change correlates with changes in PVR and mitral E/A. The rapid increase in LAVI supports the concept that left ventricular diastolic impairment and low E/A pre-PTE are due to left heart underfilling rather than inherent left ventricular diastolic dysfunction
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Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension.
BackgroundImpaired left ventricular diastolic filling is common in chronic thromboembolic pulmonary hypertension (CTEPH), and recent studies support left ventricular underfilling as a cause. To investigate this further, we assessed left atrial volume index (LAVI) in patients with CTEPH before and after pulmonary thromboendarterectomy (PTE).MethodsForty-eight consecutive CTEPH patients had pre- & post-PTE echocardiograms and right heart catheterizations. Parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), cardiac index, LAVI, & mitral E/A ratio. Echocardiograms were performed 6βΒ±β3 days pre-PTE and 10βΒ±β4 days post-PTE. Regression analyses compared pre- and post-PTE LAVI with other parameters.ResultsPre-op LAVI (mean 19.0βΒ±β7 mL/m2) correlated significantly with pre-op PVR (Rβ=β-0.45, pβ=β0.001), mPAP (Rβ=β-0.28, pβ=β0.05) and cardiac index (Rβ=β0.38, pβ=β0.006). Post-PTE, LAVI increased by 18% to 22.4βΒ±β7 mL/m2 (pβ=β0.003). This change correlated with change in PVR (765 to 311 dyne-s/cm5, pβ=β0.01), cardiac index (2.6 to 3.2 L/min/m2, pβ=β0.02), and E/A (.95 to 1.44, pβ=β0.002).ConclusionIn CTEPH, smaller LAVI is associated with lower cardiac output, higher mPAP, and higher PVR. LAVI increases by ~20% after PTE, and this change correlates with changes in PVR and mitral E/A. The rapid increase in LAVI supports the concept that left ventricular diastolic impairment and low E/A pre-PTE are due to left heart underfilling rather than inherent left ventricular diastolic dysfunction