Right atrial to left atrial volume index ratio is associated with increased mortality in patients with pulmonary hypertension

Autor:	Sula Mazimba, Hunter Mwansa, Manu Mysore, Priscilla Ababio, Andrew D. Mihalek, William C. Harding, Younghoon Kwon, Benjamin Ruth, Khadijah Breathett, Jamie L.W. Kennedy, Brandy Patterson, Christiana Jeukeng, Kimberley Chadwell, Kenneth C. Bilchick
Rok vydání:	2018
Předmět:	Male medicine.medical_specialty Hypertension Pulmonary Hemodynamics Atrial Function Right 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Heart Atria Risk factor Pulmonary wedge pressure Retrospective Studies Pressure overload Framingham Risk Score business.industry Reproducibility of Results Middle Aged medicine.disease Pulmonary hypertension Echocardiography Doppler 030228 respiratory system Quartile Cardiology Atrial Function Left Female Elevated right atrial pressure Cardiology and Cardiovascular Medicine business
Zdroj:	Echocardiography. 35:1729-1735
ISSN:	0742-2822
DOI:	10.1111/echo.14149
Popis:	BACKGROUND Pulmonary hypertension (PH) is characterized by increased pulmonary vascular resistance leading to right heart failure. Elevated right atrial (RA) pressure reflects right ventricular (RV) pressure overload and is an established risk factor for mortality in PH. We hypothesized that PH patients with an increased ratio of RA to LA volume index (RAVI/LAVI), would have increased mortality. METHODS We evaluated the association of RAVI/LAVI with mortality in 124 patients seen at a single academic center's PH clinic after adjusting for the REVEAL risk score, an established risk score in PH. LA and RA volume indices were measured in the four-and two-chamber views by two independent researchers. Multivariable logistic regression was used to model the independent association of RAVI/LAVI with survival. RESULTS Among 124 patients (mean age 62 ± 12.7 years, 68.6% female), each unit increase in RAVI/LAVI was associated with a nearly twofold increase in mortality (OR: 1.91, 95% CI: 1.20-3.04). In a multivariable logistic regression, each unit increase in RAVI/LAVI was associated with a nearly twofold increase in mortality (OR: 1.73, 95% CI: 1.003-2.998). Furthermore, RAVI/LAVI in the highest quartile (>1.42) was significantly associated with elevated right atrial pressure (RAP) to pulmonary artery wedge pressure ratio (RAP/PAWP) (0.76 ± 0.41, P = 0.02) compared with the lowest quartile (
Databáze:	OpenAIRE
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