Pulmonary artery hypertension in severe aortic stenosis: incidence and mechanism

Am Heart J. 1993 Jan;125(1):146-50. doi: 10.1016/0002-8703(93)90067-j.


We investigated the incidence and mechanism of pulmonary artery hypertension (PAH) in a consecutive series of patients with aortic stenosis who were undergoing diagnostic cardiac catheterization. Forty-five patients with severe aortic stenosis were divided into two groups: group 1 comprised 13 patients (29%) with PAH (pulmonary artery systolic pressure > 50 mm Hg); group 2 comprised 32 patients (71%) without PAH. Group 1 patients had a higher incidence of congestive heart failure, a lower left ventricular ejection fraction and cardiac index, and more mitral regurgitation as compared with group 2 patients. Of the 13 group 1 patients, 8 had a transpulmonary gradient (pulmonary artery mean pressure--pulmonary capillary wedge pressure) > or = 10 mm Hg, consistent with reactive PAH. We conclude that PAH frequently accompanies aortic stenosis and is often reactive.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / epidemiology*
  • Aortic Valve Stenosis / physiopathology
  • Cardiac Catheterization
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / epidemiology*
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / physiopathology
  • Incidence
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / epidemiology
  • Mitral Valve Insufficiency / physiopathology
  • Pulmonary Artery / physiopathology
  • Pulmonary Wedge Pressure