Title
Elevated Right Atrial Pressure Associated With Alteration Of Left Ventricular Contractility And Ventricular-Arterial Coupling In Pulmonary Artery Hypertension
Abstract
Pulmonary artery hypertension (PAH) is a progressive disorder which leads to heart failure and death. Development of dilated right ventricle (RV), progressive RV dysfunction and increased right atrial (RA) pressure make the RV transition from a compensated to a decompensated phase and eventually leads to heart failure. However, the relationship between elevated RA pressure and left ventricular contractility and ventricular arterial coupling (VAC) has not been well studied. 36 patients were recruited and underwent both right heart catheterization (RHC) and cardiac magnetic resonance (CMR). Left ventricular (LV) pressure-volume loops were reconstructed from RHC and CMR. LV contractility was assessed by end-systolic elastance (E-es) using single-beat method and arterial elastance (E-a) was estimated as the ratio of end-systolic pressure and stroke volume (SV). The VAC was calculated as the ratio of E-es and E-a (i.e. E-es/E-a). The results demonstrated a nonlinear relationship between RA pressure and E-es, RA pressure and VAC. E-es increased when RA pressure increased to 7 mmHg and then decreased when RA pressure exceeded 7 mmHg. E-es were 2.79 +/- 1.61 mmHg/ml, 4.27 +/- 1 33 mmHg/ml, 2.69 +/- 0.89 mmHg/ml and 2.36 +/- 1.10 mmHg/ml at ascending quartiles of RA pressure, respectively (quartile 1: RAP <= 5 mmHg; quartile 2: 5<; RAP <= 7 mmHg; quartile 3: 7<; RAP <= 10 mmHg and quartile 4: RAP>10 mmHg). Similarly, VAC were 1.36 +/- 0.61, 1.93 +/- 0.86, 1.16 +/- 0.55 and 0.95 +/- 0.27 the four quartiles (both ANOVA P <; 0.05). We found that there was a nonlinear relationship between RA pressure and LV contractility, and between RA pressure and ventricular-arterial coupling. A cut-off value of 7 mmHg of RAP may indicate a decompensated LV hemodynamics.
Year
DOI
Venue
2019
10.1109/EMBC.2019.8856814
2019 41ST ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC)
Field
DocType
Volume
Stroke volume,Computer science,Elevated right atrial pressure,Contractility,Artificial intelligence,Elastance,Hemodynamics,Computer vision,Heart failure,Pulmonary artery,Internal medicine,Cardiology,Quartile
Conference
2019
ISSN
Citations 
PageRank 
1557-170X
0
0.34
References 
Authors
0
18
Name
Order
Citations
PageRank
Xiaodan Zhao1548.84
Ru San Tan220018.12
Ju Le Tan301.35
Ping Chai4222.42
Lynette L. Teo500.34
Marielle V. Fortier600.34
Teng Hong Tan700.34
Shuang Leng811.50
Wen Ruan900.34
Jun-Mei Zhang1000.34
Jennifer Ann Bryant1100.34
Jonathan Yap1200.34
Ching Ching Ong1300.34
Devinder Singh1400.34
Soo Teik Lim1501.01
James W. Yip1600.34
Yucheng Chen17365.91
Liang Zhong184312.20