Pulmonary artery hypertension in severe aortic stenosis: incidence and mechanism
Department of Medicine, Division of Cardiovascular Medicine
Acute Disease; Aortic Valve Stenosis; Heart Catheterization; Hemodynamics; Humans; Hypertension, Pulmonary; Incidence; Mitral Valve Insufficiency; Pulmonary Artery; Pulmonary Wedge Pressure
Cardiology | Cardiovascular Diseases
We investigated the incidence and mechanism of pulmonary artery hypertension (PAH) in a consecutive series of patients with aortic stenosis who were undergoing diagnostic cardiac catheterization. Forty-five patients with severe aortic stenosis were divided into two groups: group 1 comprised 13 patients (29%) with PAH (pulmonary artery systolic pressure > 50 mm Hg); group 2 comprised 32 patients (71%) without PAH. Group 1 patients had a higher incidence of congestive heart failure, a lower left ventricular ejection fraction and cardiac index, and more mitral regurgitation as compared with group 2 patients. Of the 13 group 1 patients, 8 had a transpulmonary gradient (pulmonary artery mean pressure--pulmonary capillary wedge pressure) > or = 10 mm Hg, consistent with reactive PAH. We conclude that PAH frequently accompanies aortic stenosis and is often reactive.
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Citation: Am Heart J. 1993 Jan;125(1):146-50.