Left atrial size and function are related to pulmonary hypertension in coronary artery disease

Background: Left atrial (LA) size reflects diastolic burden and is a prognostic parameter of common cardiovascular death. However, the association between LA size and function and pulmonary hypertension (PH) in coronary artery disease (CAD) has not been well investigated. We hypothesized that LA size and function are associated with PH in CAD. Methods: One hundred seven patients with CAD were studied. LA size was determined in three different methods; namely, LA volume index (LAV), LA area index, and LA dimension. LAV total emptying fraction was also determined. Pulsed Doppler E, A, E/A, DT, tissue Doppler E′, A′, and E/E′ were measured. Pulmonary artery systolic pressure (PASP) was estimated. Results: All LA size parameters are significantly associated with PH. LAV emptying fraction, age, E, E/A, E/E′, and A′ were also associated with PH significantly. CAD patients with PH showed larger LA size, higher E, E/A, and E/E′ and lower LAV emptying fraction, A and A′ than CAD patients without PH. Multivariate regression analysis revealed that maximum LAV, E, E/A ratio, and age were independent predictors of PH. Maximum LAV > 35.6 mL/m² predicted PASP > 40 mmHg with a sensitivity of 83.9% and specificity of 62.2%. Conclusion: LAV is associated with PH in CAD patients. (Echocardiography 2012;29:535‐540)