Determinants of left atrial pressure in rheumatic mitral stenosis: role of left atrial compliance and "atrial stiffness".

Simple item page
dc.contributor.authorKapoor, Adityaen_US
dc.contributor.authorKumar, Sudeepen_US
dc.contributor.authorShukla, Ananden_US
dc.contributor.authorTewari, Satyendraen_US
dc.contributor.authorGarg, Navinen_US
dc.contributor.authorGoel, Pravinen_US
dc.contributor.authorSinha, Nakulen_US
dc.date.accessioned2004-01-08en_US
dc.date.accessioned2009-05-27T04:24:25Z
dc.date.available2004-01-08en_US
dc.date.available2009-05-27T04:24:25Z
dc.date.issued2004-01-08en_US
dc.description.abstractBACKGROUND: A wide range of left atrial pressures exist in rheumatic mitral stenosis despite similar mitral valve area. Left atrial compliance may be an important determinant of left atrial pressure in mitral stenosis. Data regarding left atrial compliance in rheumatic mitral stenosis and changes following balloon mitral valvotomy are scarce. METHODS AND RESULTS: Left atrial compliance and predictors of left atrial pressure were analyzed in 85 patients with mitral stenosis undergoing balloon mitral valvotomy. The stroke volume was divided by systolic rise in left atrial pressure to calculate the left atrial compliance. Systolic rise in left atrial pressure was computed as difference between amplitudes of left atrial "v" wave and "x" descent. The mean left atrial compliance prior to balloon mitral valvotomy was 2.62+/-1.20 cm3/mmHg. Following successful balloon mitral valvotomy there was a significant fall in pulmonary artery pressure, mean left atrial pressure, transmitral gradient, and significant increase in cardiac output, stroke volume and mitral valve area. There was a marked increase in left atrial compliance from 2.62+/-1.20 to 6.1+/-3.16 cm3/mmHg. On univariate analysis pulmonary artery systolic pressure, pulmonary artery diastolic pressure, pulmonary artery mean pressure, mean transmitral gradient, mitral valve area and left atrial compliance were the only correlates of left atrial pressures, while no correlation was noted with age, gender, left atrial size, cardiac output and stroke volume. Those with higher pulmonary artery pressure, higher transmitral gradient, lower mitral valve area and lower left atrial compliance had higher left atrial mean pressure, and the strongest negative correlation was noted with left atrial compliance. On multivariate analysis the strongest predictors of left atrial mean pressure were transmitral gradient and left atrial compliance. CONCLUSIONS: Patients with rheumatic mitral stenosis have markedly depressed left atrial compliance and hence have "stiff" left atria. Left atrial compliance is an important determinant of left atrial pressure, and improves immediately after successful balloon mitral valvotomy, irrespective of pre-balloon mitral valvotomy left atrial pressures.en_US
dc.description.affiliationDepartment of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. akapoor@sgpgi.ac.inen_US
dc.identifier.citationKapoor A, Kumar S, Shukla A, Tewari S, Garg N, Goel P, Sinha N. Determinants of left atrial pressure in rheumatic mitral stenosis: role of left atrial compliance and "atrial stiffness". Indian Heart Journal. 2004 Jan-Feb; 56(1): 27-31en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/4756
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAtrial Function, Left --physiologyen_US
dc.subject.meshBalloon Dilatationen_US
dc.subject.meshFemaleen_US
dc.subject.meshHemodynamics --physiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMitral Valve --physiopathologyen_US
dc.subject.meshMitral Valve Stenosis --physiopathologyen_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshPulmonary Circulation --physiologyen_US
dc.subject.meshRheumatic Heart Disease --physiopathologyen_US
dc.titleDeterminants of left atrial pressure in rheumatic mitral stenosis: role of left atrial compliance and "atrial stiffness".en_US
dc.typeJournal Articleen_US
Files
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.79 KB
Format:
Plain Text
Description:
Download
Collections
Indian Heart Journal