Abstract 12272: Precapillary Pulmonary Hypertension and Echocardiographic Determinants of Survival
Background: This is a retrospective analysis of prospectively collected data in a large population of patients with pre-capillary pulmonary hypertension (PH) to identify prognostic values of echocardiographic indices.
Methods: Consecutive patients who were referred to the Cardiology Service for PH assessment, between January 2002 and December 2011, were eligible for the study. All patients underwent a standard echocardiographic protocol defined by the British guidelines for echocardiography in PH.
Univariate and multivariate analysis were performed to define the prognostic value of echocardiographic indices. Kaplan Meier curves were employed for the assessment of survival for the most statistically significant values.
Results: The study cohort was constituted of 777 patients (514 women) with pre-capillary PH. Of those, 572 were classified as having pulmonary arterial hypertension (PAH) 130 (22.7%) of whom died. Sixty-five of 205 (31.7%) with chronic thromboembolic pulmonary hypertensive (CTEPH) died. Survival of not operated CTEPH patients was worse when compared to PAH patients.
When both causes were combined, moderate or severe tricuspid regurgitation (p≤0.001, HR=24.73), right ventricular (RV) myocardial performance index (p≤0.001, HR=5.013) and the presence of pericardial effusion (p=0.001, HR= 1.679) were independent predictors of mortality, while high cardiac output had a beneficial effect (p≤0.001, HR=0.328).
Conclusion: Severity of tricuspid regurgitation, the presence of pericardial effusion, myocardial performance index, inferior vein cava diameter and cardiac output, were all predictors of overall mortality in pre-capillary PH patients.
- © 2013 by American Heart Association, Inc.