Left atrial size and function are related to pulmonary hypertension in coronary artery disease.
BACKGROUND
Left atrial (LA) size reflects diastolic burden and is a prognostic parameter of common cardiovascular death. However, the association between LA size and function and pulmonary hypertension (PH) in coronary artery disease (CAD) has not been well investigated. We hypothesized that LA size and function are associated with PH in CAD.


METHODS
One hundred seven patients with CAD were studied. LA size was determined in three different methods; namely, LA volume index (LAV), LA area index, and LA dimension. LAV total emptying fraction was also determined. Pulsed Doppler E, A, E/A, DT, tissue Doppler E', A', and E/E' were measured. Pulmonary artery systolic pressure (PASP) was estimated.


RESULTS
All LA size parameters are significantly associated with PH. LAV emptying fraction, age, E, E/A, E/E', and A' were also associated with PH significantly. CAD patients with PH showed larger LA size, higher E, E/A, and E/E' and lower LAV emptying fraction, A and A' than CAD patients without PH. Multivariate regression analysis revealed that maximum LAV, E, E/A ratio, and age were independent predictors of PH. Maximum LAV > 35.6 mL/m(2) predicted PASP > 40 mmHg with a sensitivity of 83.9% and specificity of 62.2%.


CONCLUSIONS
LAV is associated with PH in CAD patients.
Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Yoko
Y
Miyata-Fukuoka
Masaki
M
Izumo
Yuichi
Y
Shimada
Eiji
E
Kuwahara
Swaminatha V
SV
Gurudevan
Kirsten
K
Tolstrup
Robert J
RJ
Siegel
Takahiro
T
Shiota
D000368:Aged; D016275:Atrial Function; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic