title: Relation of left atrial size to pulmonary capillary wedge pressure in severe mitral regurgitation.
abstract: 4,071 consecutive cardiac catheterizations were reviewed retrospectively to obtain 56 cases of pure mitral regurgitation among whom chest X-ray, electrocardiography and echocardiography had been performed within 10 days of catheterization. Mitral regurgitation was mild to moderate (1-2+) in 7 of the 56 cases while 49 had more severe regurgitation (3-4+). Left atrial size as measured by echocardiography was found to be enlarged in all but 2 cases. A positive correlation between left atrial size and severity of mitral regurgitation, irrespective of the height of the pulmonary capillary wedge pressure V wave was demonstrated. There was no demonstrable, predictive relationship between left atrial size and pulmonary capillary wedge pressure or electrocardiographic or chest X-ray findings. We conclude that knowledge of left atrial size is predictive of the severity of mitral regurgitation; however, it is not possible to predict the pulmonary capillary wedge pressure or height of the V waves based on a knowledge of left atrial dilatation in patients with pure mitral regurgitation.
authors.affiliation: University of Massachusetts Medical Center, Division of Cardiovascular Medicine, Worcester.
authors.forename: L A
authors.initials: LA
authors.lastname: Pape
authors.forename: J M
authors.initials: JM
authors.lastname: Price
authors.forename: J S
authors.initials: JS
authors.lastname: Alpert
authors.forename: I S
authors.initials: IS
authors.lastname: Ockene
authors.forename: B H
authors.initials: BH
authors.lastname: Weiner
mesh_terms: D000792:Angiography; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure; D013902:Radiography, Thoracic