Mitral Effective Regurgitant Orifice Area Predicts Pulmonary Artery Pressure Level in Patients with Aortic Valve Stenosis

2018 ◽  
Vol 31 (5) ◽  
pp. 570-577.e1 ◽  
Author(s):  
Giovanni Benfari ◽  
Stefano Nistri ◽  
Pompilio Faggiano ◽  
Marie-Annick Clavel ◽  
Caterina Maffeis ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Aortic Valve Stenosis ◽  
Pressure Level ◽  
Orifice Area ◽  
Artery Pressure ◽  
Regurgitant Orifice Area

Pulmonary artery pressure may be a predictor of closed aortic valve in patients managed by venoarterial extracorporeal membrane oxygenation

2020 ◽  
Vol 43 (9) ◽  
pp. 594-599
Author(s):  
Shogo Yamaguchi ◽  
Akinori Sawamura ◽  
Takahiro Okumura ◽  
Hiroo Kato ◽  
Hideo Oishi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Extracorporeal Membrane Oxygenation ◽  
Pulmonary Artery Pressure ◽  
Pulse Pressure ◽  
Left Ventricular ◽  
Artery Pressure ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Mean Pulmonary Artery Pressure

In the management of venoarterial extracorporeal membrane oxygenation, some patients present persistently closed aortic valve. However, little is known about the variables that contribute to persistently closed aortic valve. We investigated the factors that could predict persistently closed aortic valve at the time of venoarterial extracorporeal membrane oxygenation initiation. We investigated 17 patients who presented closed aortic valve immediately after the introduction of venoarterial extracorporeal membrane oxygenation. Patients who presented closed aortic valve 24 h after introduction of venoarterial extracorporeal membrane oxygenation were defined as the Closed-AV group (n = 8), while those whose aortic valve remained opened after 24 h were defined as the Open-AV group (n = 9). All patients were managed by concomitant use of intra-aortic balloon pumping. At baseline, there were no significant differences between mean arterial blood pressure, central venous pressure, and left ventricular ejection fraction. However, Closed-AV group had significantly lower mean pulmonary artery pressure and pulmonary artery pulse pressure compared to those of Open-AV group (mean pulmonary artery pressure: 15 ± 6 mmHg vs 25 ± 8 mmHg, p = 0.01; pulmonary artery pulse pressure: 3 ± 2 mmHg vs 8 ± 3 mmHg, p < 0.01). Logistic regression analyses revealed that the lower mean pulmonary artery pressure and pulmonary artery pulse pressure had the predictive value of closed aortic valve within 24 h after venoarterial extracorporeal membrane oxygenation initiation (mean pulmonary artery pressure: odds ratio = 0.78, 95% confidence interval = 0.58–0.95, p < 0.01; pulmonary artery pulse pressure: odds ratio = 0.18, 95% confidence interval = 0.01–0.61, p < 0.01). Lower mean pulmonary artery pressure and pulmonary artery pulse pressure values could predict persistent closed aortic valve 24 h after venoarterial extracorporeal membrane oxygenation initiation. Left ventricular preload derived from right heart function may have a major impact on aortic valve status.

Clinical impact of mitral regurgitation in aortic valve stenosis: Insight from effective regurgitant orifice area

2021 ◽  
Author(s):  
Caterina Maffeis ◽  
Giovanni Benfari ◽  
Stefano Nistri ◽  
Flavio L. Ribichini ◽  
Andrea Rossi
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Valve Stenosis ◽  
Clinical Impact ◽  
Orifice Area ◽  
Regurgitant Orifice Area

scholarly journals The effects of severe aortic stenosis and high pulmonary artery pressure on aortic valve replacement

2013 ◽  
Vol 03 (07) ◽  
pp. 428-432
Author(s):  
Faruk Toktas ◽  
Arif Gucu ◽  
Gunduz Yumun ◽  
Cuneyt Eris ◽  
Serhat Yalcinkaya ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Pulmonary Artery ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Pulmonary Artery Pressure ◽  
Severe Aortic Stenosis ◽  
Artery Pressure

scholarly journals Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

2021 ◽  
Vol 10 (17) ◽  
pp. 3878
Author(s):  
Lukas Weber ◽  
Hans Rickli ◽  
Philipp K. Haager ◽  
Lucas Joerg ◽  
Daniel Weilenmann ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Valve Replacement ◽  
Pulmonary Artery Pressure ◽  
Left Ventricular Ejection ◽  
Aortic Valve Area ◽  
Artery Pressure ◽  
Valve Area

(1) Background: Pulmonary hypertension after aortic valve replacement (AVR; post-AVR PH) carries a poor prognosis. We assessed the pre-AVR hemodynamic characteristics of patients with versus without post-AVR PH. (2) Methods: We studied 205 patients (mean age 75 ± 10 years) with severe AS (indexed aortic valve area 0.42 ± 0.12 cm2/m2, left ventricular ejection fraction 58 ± 11%) undergoing right heart catheterization (RHC) prior to surgical (70%) or transcatheter (30%) AVR. Echocardiography to assess post-AVR PH, defined as estimated systolic pulmonary artery pressure > 45 mmHg, was performed after a median follow-up of 15 months. (3) Results: There were 83/205 (40%) patients with pre-AVR PH (defined as mean pulmonary artery pressure (mPAP) ≥ 25 mmHg by RHC), and 24/205 patients (12%) had post-AVR PH (by echocardiography). Among the patients with post-AVR PH, 21/24 (88%) had already had pre-AVR PH. Despite similar indexed aortic valve area, patients with post-AVR PH had higher mPAP, mean pulmonary artery wedge pressure (mPAWP) and pulmonary vascular resistance (PVR), and lower pulmonary artery capacitance (PAC) than patients without. (4) Conclusions: Patients presenting with PH roughly one year post-AVR already had worse hemodynamic profiles in the pre-AVR RHC compared to those without, being characterized by higher mPAP, mPAWP, and PVR, and lower PAC despite similar AS severity.

Inflammation and Congenital Heart Disease Associated Pulmonary Hypertension

2015 ◽  
Vol 18 (1) ◽  
pp. 038 ◽  
Author(s):  
Mete Gursoy ◽  
Ece Salihoglu ◽  
Ali Can Hatemi ◽  
A. Faruk Hokenek ◽  
Suleyman Ozkan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cell Distribution ◽  
Inflammation Markers ◽  
Distribution Width ◽  
Artery Pressure ◽  
Lymphocyte Ratio ◽  
Mean Pulmonary Artery Pressure ◽  
Pulmonary Arterial

<strong>Background:</strong> Increased blood flow may trigger pulmonary arterial wall inflammation, which may influence progression of pulmonary artery hypertension in patients with congenital heart disease. In this study, we aimed to investigate the correlation between preoperative inflammation markers and pulmonary arterial hypertension. <br /><strong>Methods:</strong> A total of 201 patients with pulmonary hypertension were enrolled in this study retrospectively; they had undergone open heart surgery between January 2012 and December 2013. Patients’ preoperative C-reactive protein (CRP), neutrophil to lymphocyte ratio, red blood cell distribution width, pulmonary pressures, and postoperative outcomes were evaluated.<br /><strong>Results:</strong> Patient age, neutrophil to lymphocyte ratio, red blood cell distribution width, and CRP were found to be significantly correlated with both preoperative peak and mean pulmonary artery pressures. These data were entered into a linear logistic regression analysis. Patient age, neutrophil to lymphocyte ratio, and CRP were found to be independently correlated with peak pulmonary pressure (P &lt; .001, P &lt; .001, and P = .004) and mean pulmonary artery pressure (P &lt; .001, P &lt; .001, and P = .001), whereas preoperative mean pulmonary artery pressure was found to be independently correlated with intensive care unit stay (P &lt; .001). No parameter was found to be significantly correlated with extubation time and mortality. Eighteen patients had experienced pulmonary hypertensive crisis; in this subgroup, patients’ mean pulmonary artery pressure and neutrophil to lymphocyte ratio were found to be significant (P = .047, P = .003). <br /><strong>Conclusion:</strong> Preoperative inflammation markers may be correlated with the progression of pulmonary hypertensive disease, but further studies with larger sample size are needed to determine the predictive role of these markers for postoperative outcomes.<br /><br />

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