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Right atrial volume and phasic function in pulmonary hypertension

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Title: Right atrial volume and phasic function in pulmonary hypertension
Authors: Sato, Takahiro Browse this author
Tsujino, Ichizo Browse this author →KAKEN DB
Oyama-Manabe, Noriko Browse this author →KAKEN DB
Ohira, Hiroshi Browse this author
Ito, Yoichi M. Browse this author
Yamada, Asuka Browse this author
Ikeda, Daisuke Browse this author
Watanabe, Taku Browse this author
Nishimura, Masaharu Browse this author →KAKEN DB
Keywords: Pulmonary arterial hypertension
Chronic thromboembolic pulmonary hypertension
Magnetic resonance imaging
Issue Date: 20-Sep-2013
Publisher: Elsevier ireland ltd
Journal Title: International journal of cardiology
Volume: 168
Issue: 1
Start Page: 420
End Page: 426
Publisher DOI: 10.1016/j.ijcard.2012.09.133
PMID: 23058342
Abstract: Background: Few studies have focused on right atrial (RA) structure and function in pulmonary hypertension (PH). We sought to evaluate RA volume and phasic function using cardiac magnetic resonance (CMR), and to examine their clinical relevance in PH. Methods: We prospectively studied 50 PH patients and 21 control subjects. RA volume and indices of phasic function (reservoir volume, ejection fraction [EF], and conduit volume) were evaluated by CMR. Results: Maximum RA volume index was significantly higher in PH patients (56 [44-70] ml/m(2)) than in controls (40 [30-48] ml/m(2)) (p<0.001). Reservoir volume index was significantly lower in PH than in controls (p<0.001), but conduit volume index was higher in PH than in controls (p=0.008). RA EF was similar when comparing the two groups (p=0.925). Interestingly, RA EF was increased in PH patients with WHO functional class III patients as compared with controls (p<0.001) but was reduced in advanced PH patients with WHO functional class IV (p<0.01). Maximum RA volume and RA EF significantly correlated with pulmonary hemodynamic indices, atrial and brain natriuretic hormone levels, and CMR-derived right ventricular indices. By contrast, RA reservoir volume correlated with cardiac index and 6-minute walk distance. Conclusions: PH is associated with increased size, decreased reservoir function, and increased conduit function of the right atrium. RA systolic function indicated by RA EF increases in patients with mild to moderate PH but decreases in patients with advanced PH. Varying associations between RA indices and conventional PH indices suggest their unique role in the management of PH. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 辻野 一三

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