Pulmonary artery pressure and diastolic dysfunction in normal left ventricular systolic function.

Area of Science:

• Cardiology
• Echocardiography
• Pulmonary Hypertension

Background:

• Pulmonary arterial hypertension commonly follows left ventricular (LV) systolic dysfunction.
• The link between LV diastolic dysfunction and pulmonary hypertension in patients with normal LV systolic function requires further investigation.

Purpose of the Study:

• To assess the correlation between diastolic dysfunction and pulmonary arterial hypertension.
• To evaluate pulmonary artery pressure (PAP) in patients with normal left ventricular (LV) systolic function and varying degrees of diastolic dysfunction.

Main Methods:

• Retrospective analysis of 477 echocardiographic studies in patients with normal LV systolic function.
• Correlation of diastolic function grades (normal, impaired relaxation, pseudo-normal, restrictive) with echocardiographically assessed pulmonary artery pressure (PAP).
• Exclusion of subjects with other known causes of pulmonary hypertension.

Main Results:

• Mean PAP was 31.1+/-6 mm Hg in normal diastolic function (n=110).
• Mean PAP increased with diastolic dysfunction severity: 35.6+/-10.2 mm Hg (grade 1), 38.9+/-10.6 mm Hg (grade 2), and 55.1+/-11.4 mm Hg (grade 3).
• Significant differences in PAP were observed between all diastolic dysfunction grades (p<0.001).

Conclusions:

• Left ventricular diastolic dysfunction is associated with elevated pulmonary artery pressure in individuals with preserved systolic function.
• Pulmonary artery pressure significantly increases with each progressive grade of diastolic dysfunction.