Echocardiographic correlates of severe pulmonary hypertension in adult patients with ostium secundum atrial septal defect

Autor:	Navin C. Nanda, Candace Keirns, Juan Verdejo-Paris, Marco Antonio Martínez-Ríos, Karina Del Valle Zamora, Nilda Espinola-Zavaleta, Anezi Uzendu, Jorge Cossío-Aranda
Rok vydání:	2016
Předmět:	Adult Male medicine.medical_specialty Hypertension Pulmonary 030204 cardiovascular system & hematology Severity of Illness Index Heart Septal Defects Atrial Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Clinical history Diastole Internal medicine medicine.artery Medicine Humans Radiology Nuclear Medicine and imaging Diastolic function 030212 general & internal medicine Ostium secundum atrial septal defect Retrospective Studies Adult patients business.industry Middle Aged medicine.disease Pulmonary hypertension Echocardiography Doppler Pulmonary artery cardiovascular system Cardiology Female Transthoracic echocardiogram Cardiology and Cardiovascular Medicine business
Zdroj:	Echocardiography (Mount Kisco, N.Y.). 33(12)
ISSN:	1540-8175
Popis:	To identify echocardiographic factors that correlate with pulmonary hypertension (PH) in adults with ostium secundum atrial septal defect (ASD).Between November 2009 and November 2013, 92 adults with ASD were studied. All had clinical history and transthoracic echocardiogram.Thirty-nine percent of patients had severe PH defined as systolic pulmonary artery pressure (sPAP) of 70 mm Hg or more. The size of ASD (31.84±8.21 mm) and a right-sided tricuspid inflow E-wave to tissue Doppler e'-wave ratio6.2 correlated with severe PH with AUC of 0.704 (CI 95%=0.59 to 0.818, P.001) and 0.65 (CI 95%=0.531 to 0.773, P.014), respectively. Multivariate logistic regression showed that sPAP70 mm Hg was the variable that most precisely correlated with right ventricular (RV) dysfunction as evidenced by TAPSE17 mm and RV fractional shortening area (RVFSA)35%. Left ventricular (LV) diastolic function was also significantly reduced in the group with severe PH with mitral inflow E/A ratio of 0.73±0.23 vs 1.13±0.42 in the group without severe PH (sPAP70 mm Hg, (P=.001). The pulmonary (Qp) to systemic (Qs) cardiac output ratio (3.09±1.12) and right-sided tissue Doppler S9.5 cm/s most accurately predicted a Tei index0.55.Larger size of ASD using the QP/QS ratio and increased right-sided tricuspid E/e' ratio correlated with severe PH with a sPAP of 70 mm Hg or more. Patients with severe PH had more severe RV dysfunction as evaluated by TAPSE and RVFSA in comparison to those with PH70 mm Hg. LV diastolic function was also reduced in the severe PH group.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b4d8e4943765ead07232200592c584ac https://pubmed.ncbi.nlm.nih.gov/27596111 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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