• Grace Casaclang-Verzosa, Vuyisile T Nkomo, Maurice E Sarano, Joseph F Malouf, Fletcher A Miller, and Jae K Oh.
• Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
• J Am Soc Echocardiogr. 2008 Jul 1; 21 (7): 824-7.

ObjectiveOur aim was to determine echocardiographic Doppler predictors of pulmonary artery systolic pressure (PASP) in patients with moderate to severe aortic stenosis (AS).MethodsIn this retrospective study of 50 patients with moderate to severe AS, the determinants of PASP were analyzed.ResultsAortic valve area was 0.84 +/- 0.3 cm(2), with mean gradient of 55 +/- 16 mm Hg, mean ejection fraction (EF) of 60 +/- 13%, mean PASP of 37 +/- 15 mm Hg, and mean E/Ea of 14 +/- 6. aortic valve area and mean gradient did not predict degree of PASP and were not associated with EF and diastolic parameters. LV mass index (P = .0005), E velocity (P = .006), E/Ea (P < .0001), and EF (P < .0001) were univariately significantly associated with PASP. By multivariate analysis, E/Ea independently predicted PASP (P = .0001).ConclusionOur findings suggest that in moderate to severe AS, diastolic function, not AS severity, determines PASP. Superimposed diastolic dysfunction likely contributes to clinical symptoms of moderate to severe AS.

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