Left ventricular dimensions in pulmonary arterial hypertension: haemodynamic and exercise correlations

Abstract

ABSTRACTBackground: Remodelling of the heart in patients with pulmonary arterial hypertension (PAH) involves both the right and left ventricles. The objective of the present study was to analyse the dimensions of the right and left ventricles as assessed by echocardiography, and to compare this with haemodynamics and exercise capacity in patients with PAH.Materials and methods: Transthoracic echocardiogram, exercise capacity as assessed by the 6-minute walk test and right-heart catheterization were performed within 1 week in 66 consecutive patients with PAH. Univariate correlation and multiple regression analyses were performed to relate echocardiographic and clinical variables.Results: Left ventricular end-diastolic area index had the best correlation with cardiac index (r = 0.62; p < 0.001) and 6-minute walk distance (r = 0.56; p < 0.001). The ratio of the right to left ventricular area correlated with right atrial pressure (r = 0.62; p < 0.001). Right ventricular percent change in area correlated with cardiac index (r = 0.51; p < 0.001). No correlations were observed between the right and left ventricular dimensions.Conclusions: Left ventricular dimensions and the ratio of the right to left ventricular area correlated with resting haemodynamics and exercise capacity in patients with pulmonary arterial hypertension. These correlations were stronger than those observed with right ventricular dimensions alone. Left ventricular dimensions are important for the non-invasive evaluation of severity of patients with pulmonary arterial hypertension.