title: E/Ea is the major determinant of pulmonary artery pressure in moderate to severe aortic stenosis.
abstract: OBJECTIVE
  Our aim was to determine echocardiographic Doppler predictors of pulmonary artery systolic pressure (PASP) in patients with moderate to severe aortic stenosis (AS).
  
  
  METHODS
  In this retrospective study of 50 patients with moderate to severe AS, the determinants of PASP were analyzed.
  
  
  RESULTS
  Aortic valve area was 0.84 +/- 0.3 cm(2), with mean gradient of 55 +/- 16 mm Hg, mean ejection fraction (EF) of 60 +/- 13%, mean PASP of 37 +/- 15 mm Hg, and mean E/Ea of 14 +/- 6. aortic valve area and mean gradient did not predict degree of PASP and were not associated with EF and diastolic parameters. LV mass index (P = .0005), E velocity (P = .006), E/Ea (P < .0001), and EF (P < .0001) were univariately significantly associated with PASP. By multivariate analysis, E/Ea independently predicted PASP (P = .0001).
  
  
  CONCLUSIONS
  Our findings suggest that in moderate to severe AS, diastolic function, not AS severity, determines PASP. Superimposed diastolic dysfunction likely contributes to clinical symptoms of moderate to severe AS.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Casaclang-Verzosa
authors.forename: Vuyisile T
authors.initials: VT
authors.lastname: Nkomo
authors.forename: Maurice E
authors.initials: ME
authors.lastname: Sarano
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Malouf
authors.forename: Fletcher A
authors.initials: FA
authors.lastname: Miller
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
mesh_terms: D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology