Related Experiment Video

Updated: Sep 2, 2025

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
08:37

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Published on: April 18, 2025

417

Low left atrial volume is an independent predictor of persistent hypotension after carotid artery stenting

Kota Maekawa1, Nobuyuki Ohara2, Junji Takasugi2

  • 1Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan k_mae21@kuhp.kyoto-u.ac.jp.

Journal of Neurointerventional Surgery
|August 2, 2022
PubMed

Insights

Lower left atrial (LA) volume predicts persistent hypotension (PH) after carotid artery stenting (CAS). Preoperative hydration may help prevent PH in patients undergoing CAS.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Neurosurgery

Background:

  • Persistent hypotension (PH) is a common complication after carotid artery stenting (CAS).
  • Predictors for PH after CAS remain unclear.
  • Lower left atrial (LA) volume is a potential predictor, analogous to vasovagal syncope mechanisms.

Purpose of the Study:

  • To investigate if left atrial (LA) volume can predict persistent hypotension (PH) after carotid artery stenting (CAS).

Main Methods:

  • Retrospective analysis of 212 patients undergoing CAS (March 2013-February 2021).
  • Patients were grouped based on the presence or absence of PH for over 1 hour post-CAS.
  • Transthoracic echocardiograms were used to assess left atrial volume index (LAVI).

Main Results:

  • Persistent hypotension (PH) occurred in 24.5% of patients.
  • Lower LAVI was significantly associated with PH (29.7 vs 37.7 mL/m², p<0.001).
  • LAVI <33.5 mL/m² independently predicted PH (OR 4.950), and preoperative hydration was protective (OR 0.235).

Conclusions:

  • Reduced left atrial (LA) volume is an independent predictor of persistent hypotension (PH) after carotid artery stenting (CAS).
  • Preoperative hydration may serve as a preventative measure against PH post-CAS.
Abstract

Keywords:
AtherosclerosisBlood PressureCatheterPlaqueStent

More Related Videos

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge09:32

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

Published on: January 20, 2023

3.6K
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery04:48

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Published on: November 28, 2018

8.0K

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
30
Regulation of Stroke Volume01:27

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
3.4K
Cardiac Output II: Effect of Stroke Volume on Cardiac Output01:22

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
1.3K
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
31
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
46