Abstract 19015: Characteristics of Patients with Pulmonary Hypertension but without Cardiovascular Diseases: a Study with Echocardiography
Background: Pulmonary hypertension (PH) is frequently a manifestation of various systemic and cardiac diseases. While pulmonary artery pressure is now estimated in a routine part of an echo examination, such data have not been analyzed from the epidemiologic viewpoint, yet.
Objective: The objective of this study is to clarify the underlying diseases in PH patients without cardiovascular diseases.
Methods: PH was present in 2244 of 9491 subjects in whom echo study was done from January to December 2007, if PH was identified as the continuous wave Doppler-determined transtricuspid pressure gradient (TR-PG) of 25 mmHg or over. We retrospectively analyzed the prevalence of hypertension, atrial fibrillation, cancer, pulmonary disease, anemia, chronic kidney disease, collagen disease, and so on in the 2244 subjects. We measured mitral early diastolic flow velocity (E) and mitral anulus early diastolic velocity (E′) to estimate left atrial pressure (LAP) with the E/E′ ratio.
Results: PH was present in 949 subjects without LV systolic dysfunction (ejection fraction < 50%) or cardiac diseases, such as ischemic heart diseases, cardiomyopthy, and moderate-to-severe valvular heart disease. E/e′ was 15 or greater, suggestive of the increased LAP in 310 of those with PH. TR-PG was 35 mmHg or less (mild PH) in 721, between 35 and 45 mmHg in 161, and 45 mmHg or over (severe PH) iin 67. The prevalence of hypertension was the most frequent in those with mild PH (figure1), while atrial fibrillation, in those with severe PH (figure 2).
Conclusions: Mild PH is seen with a high frequency even without the cardiac diseases. PH is not attributed to increased LAP in about two-thirds of such cases.
- © 2010 by American Heart Association, Inc.