A rare location for cardiac ... Aortic coarctation and desce ... Surgical treatment of an iso ... Comparison of the sternal wi ... Isolated insufficiency of th ... Esophagitis and gastritis ar ... Comparison of conventional e ... Removal of a missed guide wi ... Giant external iliac artery ... Prosthetic mitral valve dehi ... View All

Mitral valve replacement in ... Removal of a missed guide wi ... Surgical treatment of an iso ... Aortic coarctation and desce ... Comparison of conventional e ... PERSPECTIVE FROM the EDITOR ... A comparison of quality of l ... Right anterior thoracotomy a ... Surgery of mitral valve dise ... Isolated insufficiency of th ... View All

Back | Table of Contents | Full Text | PDF | Similar Articles |

The association of left atrial and ventricular strain and volumetric parameters with clinical, biohormonal, and hemodynamic data in patients with pulmonary arterial hypertension

Tugba Aktemur¹, Nertila Poci², Cihangir Kaymaz<sup>3

1</sup>Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
²Department of Cardiology, Herzzentrum Bodensee, Konstanz, Germany
³Department of Cardiology, Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Türkiye

Keywords: Left atrium and ventricle, pulmonary arterial hypertension, three dimensional echocardiography

---

Objectives: This study aimed to demonstrate left atrial and left ventricular three-dimensional volume and two-dimensional strain characteristics and their relationship with clinical status, neurohormonal markers, and invasive parameters measured by right heart catheterization in patients with pulmonary arterial hypertension.

Patients and methods: Thirty-one patients (16 females, 15 males; mean age: 42.3±15.0 years; range, 21 to 71 years) were enrolled in this cross-sectional study between June 2013 and January 2014. Transthoracic echocardiography and right and left heart catheterization were performed. B-type natriuretic peptide (BNP) and uric acid levels were evaluated. Patients were evaluated in two groups regarding the requirement of hospitalization in the one-year period, tricuspid annular plane systolic excursion (TAPSE) values, and right ventricle lateral wall tissue Doppler systolic velocity (St) values. A TAPSE <1.6 cm and an St <10 cm/sec were considered worse outcomes. Groups were compared in terms of hemodynamic, neurohormonal, and echocardiographic data.

Results: Hospitalized patients had lower 6-min walk test values (332.80±135.46 vs. 449.75±73.49, p=0.01) compared to those who were not hospitalized. Hospitalized patients had higher BNP levels [145.85 (11.82-688.66) vs. 36.62 (8.76-880.88), p=0.02]. The 6-min walk distance had a significant effect on predicting hospitalization (p<0.05; CI: 0.64-0.99). Considering the odds ratio, it was illustrated that the 6-min walk distance had a 0.96-fold effect in hospitalized patients compared to patients who were not hospitalized. Patients with lower TAPSE values had a lower left atrial end-systolic volume (15.98±7.40 vs. 25.48±12.31, p=0.01) and a lower left atrial expansion index (58.88±42.1 vs. 142.14±73.38, p=0.01). Left atrial ejection fraction was significantly lower in patients with lower St values (0.37±0.13 vs. 0.54±0.13, p=0.001).

Conclusion: Pulmonary arterial hypertension patients with lower TAPSE values tended to have a lower left atrial volume and left atrial volume index. The traditional parameters, such as BNP and 6-min walk test, were predictors of hospitalization in patients with pulmonary arterial hypertension.

Back | Table of Contents | Full Text | PDF | Similar Articles |