Abstract 13970: Precapillary Pulmonary Hypertension Prior to LVAD Implantation is Associated with Increased Mortality
Introduction: Severe left ventricular (LV) dysfunction is often associated with pulmonary hypertension (PH). Data suggests that in PH patients worsening LV function can result in “out-of-proportion” PH (OOPPH), measured by the transpulmonary gradient (TPG) or diastolic pulmonary vascular pressure gradient (DPG), and portends a higher mortality. We hypothesized that patients with OOPPH who underwent left ventricular assist device (LVAD) placement would have worse outcomes, and we wanted to assess outcomes in pre and postcapillary PH patients.
Methods: We retrospectively identified all patients who underwent LVAD placement with RHC hemodynamic data available between Jan 1st 2007 and Dec 31st 2011. Demographic, clinical and procedural data were collated and analyzed. Multivariable analysis was used to assess for predictors of mortality.
Results: Within the patient cohort (n = 79), the mean age was 54 (range 20 - 78), 75% were male, and 78% were Caucasian. Precapillary PH was present in 10% of the patients and was an independent predictor for mortality (HR 4.71, 95% CI [1.53 - 14.5] p=0.007) after adjusting for race, gender, age and inotrope use. OOPPH was not associated with increased mortality.
Conclusion: In our institutional experience precapillary PH has shown to be an independent predictor for mortality in the setting of LVAD placement. These findings are intriguing and merit further investigation on a larger scale.
Author Disclosures: B.C. Lee: None. S.A. Smith: None.
- © 2014 by American Heart Association, Inc.