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Association of left atrial pressure with left atrial volume and N-terminal prohormone brain natriuretic peptide in children with cardiomyopathy

Published online by Cambridge University Press:  31 July 2018

Arpit Agarwal ,
Suying Lam ,
Hua Li ,
Sudheer R. Gorla ,
Nao Sasaki ,
Paolo G. Rusconi  and
Sethuraman Swaminathan Open the ORCID record for Sethuraman Swaminathan [Opens in a new window]
Arpit Agarwal
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA
Suying Lam
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA
Hua Li
Affiliation:
Department of Public Health Sciences, Division of Biostatistics, University of Miami Miller School of Medicine, Miami, FL, USA
Sudheer R. Gorla
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA
Nao Sasaki
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA
Paolo G. Rusconi
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA
Sethuraman Swaminathan*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA
*
Author for correspondence: S. Swaminathan, MD, Department of Pediatrics, Division of Pediatric Cardiology, Jackson Memorial Hospital/University of Miami Miller School of Medicine, 1611 NW 12th Avenue, NW 109, Miami, FL 33136, USA. Tel: 305 585 6683; Fax: 305 324 6012. E-mail: sswami@miami.edu
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Abstract

Background

Enlargement of the left atrium is a non-invasive marker of diastolic dysfunction of the left ventricle, a determinant of prognosis in children with cardiomyopathy. Similarly, N-terminal prohormone brain natriuretic peptide is a useful marker in the management of children with cardiomyopathy and heart failure. The aim of this study is to evaluate the association of left atrial pressures with left atrial volume and N-terminal prohormone brain natriuretic peptide in children with cardiomyopathy.

Methods

This was a retrospective study reviewing the medical records of patients <18 years of age, who were diagnosed with cardiomyopathy or acute myocarditis with eventual development of cardiomyopathy. Left atrial volume by transthoracic echocardiogram and pulmonary capillary wedge pressure, a surrogate of left atrial pressure, obtained by means of cardiac catheterisation were analysed. In addition, N-terminal prohormone brain natriuretic peptide levels obtained at the time of the cardiac catheterisation were also reviewed. Statistical analysis was performed to evaluate the association of left atrial pressures with left atrial volume and N-terminal prohormone brain natriuretic peptide levels.

Results

There was a linear correlation of left atrial pressure estimated in the cardiac catheterisation with indexed left atrial volume (r=0.63; p<0.001) and left atrial volume z-scores (r=0.59; p<0.001). We found no statistically significant association between the left atrial pressure and N-terminal prohormone brain natriuretic peptide levels.

Conclusions

Left atrial volume measured non-invasively by echocardiography can be used as a surrogate for left atrial pressure in assessing diastolic dysfunction of the left ventricle in children with cardiomyopathy. The larger the size of the left atrium, worse is the diastolic function of the left ventricle.

Keywords

Cardiomyopathyleft atrial pressureleft atrial volumeN-terminal prohormone brain natriuretic peptide
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 11 , November 2018 , pp. 1333 - 1337
Copyright
© Cambridge University Press 2018 

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