Determinants of pulmonary hypertension development in moderate or severe aortic stenosis

Hyo Suk Ahn, Sung A. Chang, Hyung Kwan Kim, Seon Jin Kim, Seung Pyo Lee, Sung Ji Park, Yong Jin Kim, Goo Yeong Cho, Dae Won Sohn, Jae K. Oh

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Pulmonary hypertension (PHT) is not uncommon in patients with aortic stenosis (AS) and portends a dismal prognosis. We attempted to determine the prevalence of PHT and to identify contributors to its development in patients with moderate or severe AS. A total of 189 patients were enrolled. Patients were divided into two groups according to the presence or absence of PHT, with a pulmonary artery systolic pressure cutoff value of 40 mmHg. Left ventricular (LV) systolic function was assessed by global longitudinal (LV-GLS), circumferential (LV-GCS) and radial (LV-GRS) strains on top of LV ejection fraction (LV-EF). The ratio of mitral E to septal mitral annular e′ velocity (E/e′) was calculated to estimate LV filling pressure. Fifty patients (26.5 %) had concomitant PHT. Patients with PHT had a higher prevalence of diabetes, a lower LV-EF, a higher E/e′, a larger left atrial volume index, a smaller indexed aortic valve (AV) area, and a more reduced LV-GLS (all p < 0.05). However, LV-GRS and LV-GCS were similar in patients with or without PHT. On multivariate logistic regression analysis, LV-GLS and E/e′ were independently associated with PHT, whereas LV-EF and indexed AV area were not. PHT complicating moderate or severe AS is commonly found and is independently associated with systolic and diastolic dysfunction assessed by Doppler and strain imaging, but not with LV-EF.

Original languageEnglish (US)
Pages (from-to)1519-1528
Number of pages10
JournalInternational Journal of Cardiovascular Imaging
Volume30
Issue number8
DOIs
StatePublished - Dec 2014

Keywords

  • Aortic stenosis
  • Echocardiography
  • Global longitudinal strain
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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