Skip to main content
Journal cover image

Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension.

Publication ,  Journal Article
Marston, NA; Auger, WR; Madani, MM; Kimura, BJ; Strachan, GM; Raisinghani, AB; DeMaria, AN; Blanchard, DG
Published in: Cardiovasc Ultrasound
August 11, 2014

BACKGROUND: Impaired 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). METHODS: Forty-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 6 ± 3 days pre-PTE and 10 ± 4 days post-PTE. Regression analyses compared pre- and post-PTE LAVI with other parameters. RESULTS: Pre-op LAVI (mean 19.0 ± 7 mL/m2) correlated significantly with pre-op PVR (R = -0.45, p = 0.001), mPAP (R = -0.28, p = 0.05) and cardiac index (R = 0.38, p = 0.006). Post-PTE, LAVI increased by 18% to 22.4 ± 7 mL/m2 (p = 0.003). This change correlated with change in PVR (765 to 311 dyne-s/cm5, p = 0.01), cardiac index (2.6 to 3.2 L/min/m2, p = 0.02), and E/A (.95 to 1.44, p = 0.002). CONCLUSION: In 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.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cardiovasc Ultrasound

DOI

EISSN

1476-7120

Publication Date

August 11, 2014

Volume

12

Start / End Page

32

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Sensitivity and Specificity
  • Retrospective Studies
  • Reproducibility of Results
  • Pulmonary Embolism
  • Organ Size
  • Middle Aged
  • Male
  • Hypertension, Pulmonary
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Marston, N. A., Auger, W. R., Madani, M. M., Kimura, B. J., Strachan, G. M., Raisinghani, A. B., … Blanchard, D. G. (2014). Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension. Cardiovasc Ultrasound, 12, 32. https://doi.org/10.1186/1476-7120-12-32
Marston, Nicholas A., William R. Auger, Michael M. Madani, Bruce J. Kimura, G Monet Strachan, Ajit B. Raisinghani, Anthony N. DeMaria, and Daniel G. Blanchard. “Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension.Cardiovasc Ultrasound 12 (August 11, 2014): 32. https://doi.org/10.1186/1476-7120-12-32.
Marston NA, Auger WR, Madani MM, Kimura BJ, Strachan GM, Raisinghani AB, et al. Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension. Cardiovasc Ultrasound. 2014 Aug 11;12:32.
Marston, Nicholas A., et al. “Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension.Cardiovasc Ultrasound, vol. 12, Aug. 2014, p. 32. Pubmed, doi:10.1186/1476-7120-12-32.
Marston NA, Auger WR, Madani MM, Kimura BJ, Strachan GM, Raisinghani AB, DeMaria AN, Blanchard DG. Assessment of left atrial volume before and after pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension. Cardiovasc Ultrasound. 2014 Aug 11;12:32.
Journal cover image

Published In

Cardiovasc Ultrasound

DOI

EISSN

1476-7120

Publication Date

August 11, 2014

Volume

12

Start / End Page

32

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Sensitivity and Specificity
  • Retrospective Studies
  • Reproducibility of Results
  • Pulmonary Embolism
  • Organ Size
  • Middle Aged
  • Male
  • Hypertension, Pulmonary