Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Nilda Espinola-Zavaleta, Jorge Cossio-Aranda, Karina Del Valle Zamora and Navin C Nanda
National Institute of Cardiology Ignacio Chavez, Mexico
University of Alabama, USA
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Aim: Aim of this study is to identify echocardiographic factors that correlate with pulmonary hypertension (PH) in adults with ostium secundum atrial septal defect (ASD). Methods: From November 2009 to November 2013, 92 adults with ASD were studied. All had clinical history and transthoracic echocardiogram. Results: 39% of patients had severe PH defined as systolic pulmonary artery pressure (sPAP) of 70 mm Hg or more. The size of ASD (31.84�±8.21 mm) and a right sided tricuspid inflow E wave to tissue Doppler e�´wave ratio >6.2 correlated with severe PH with AUC of 0.704 (CI 95%=0.59 to 0.818, p<0.001) and 0.65 (CI 95%=0.531 to 0.773, p<0.014), respectively. Multivariate logistic regression showed that sPAP>70 mm Hg was the variable that most precisely correlated with right ventricular (RV) dysfunction as evidenced by TAPSE <17 mm and RV fractional shortening area (RVFSA) <35%. Left ventricular (LV) diastolic function was also significantly reduced in the group with severe PH mitral inflow E/A ratio of 0.73�±0.23 vs. 1.13�±0.42 in the group without severe PH (sPAP<70 mm Hg, (p=0.001). The pulmonary (Qp) to systemic (Qs) cardiac output ratio (3.09�±1.12) and right sided tissue Doppler S<9.5 cm/sec most accurately predicted a Tei index>0.55. Conclusions: Larger size of ASD using the QP/QS ratio and increased right-sided tricuspid E/eâ�� ratio correlated with severe PH with a sPAP of 70 mm Hg or more. Patients with severe PH had more severe RV dysfunction as evaluated by TAPSE and RVFSA in comparison to those with PH <70 mm Hg. LV diastolic function was also reduced in the severe PH group.
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