Echocardiography for Pulmonary Hypertension Risk Prediction
Summary of Key Findings from the Text:
This text presents findings from a study of 102 patients with Pulmonary Arterial Hypertension (PAH). Here’s a breakdown of the key information:
1.Patient Population & Diagnosis:
Total Patients: 102
Patients with Echocardiographic Data: 77
PAH Subtypes (most common first):
Connective Tissue Disease-Associated PAH (45 patients)
Idiopathic PAH (20 patients)
Other (12 patients)
diagnostic criteria (following 2022 ESC/ERS guidelines):
Mean Pulmonary Arterial Pressure > 20 mm Hg at rest
Maximum Pulmonary Capillary Wedge Pressure ≤ 15 mm Hg
Pulmonary Vascular Resistance > 2 WU
2. Mortality & Patient Characteristics:
In-hospital mortality: Patients who died in hospital were slightly older (58 vs 56 years) and predominantly White (67%) and female (86%).
1-year mortality: Similar demographics to in-hospital deaths, with a majority being White (75%) and female (80%).
WHO Functional Class: Most patients were in Class III at baseline, nonetheless of survival status (48-55% for both 1-year and in-hospital groups).
Ventilation History: A significant proportion of patients had a history of both invasive (11-35%) and non-invasive ventilation (65-75%). Invasive ventilation history was significantly different between groups (P = .04). Tricuspid regurgitation: Moderate or severe tricuspid regurgitation was more common in both the 1-year and in-hospital mortality groups (P =.047 and P = .08, respectively).
3. Follow-up duration (Median):
1-year mortality survivors: 365 days
1-year mortality nonsurvivors: 30.1 days
In-hospital mortality survivors: 6 days
In-hospital mortality nonsurvivors: 3.5 days
4. Differences Between Survivors & Nonsurvivors:
A. 1-Year Mortality:
Nonsurvivors vs. Survivors:
Worsened Tricuspid Regurgitation (P = .047)
Lower Left Ventricular End-Diastolic Volume (LVEDV): 47 vs 61 mL (P = .01)
Reduced Tricuspid Annular Plane Systolic Excursion (TAPSE): 11 vs 17 mm (P < .001)
Impaired Global Right Ventricular Free Wall Strain (RVFWSglobal): -14% vs -11% (P = .01)
Reduced Right Atrium (RA) reservoir: 15% vs 20% (P =.045)
B. In-Hospital Mortality:
Nonsurvivors vs. Survivors:
Worse RV Systolic Function (lower TAPSE): 11 vs 15 mm (P = .01)
Greater RVFWSglobal: -13% vs -10% (P = .01)
Reduced RA Reservoir: 13% vs 19% (P = .01)
reduced RA Booster Strain: -11% vs -6% (P = .01)
* Reduced R… (text is cut off here)
In essence, the study highlights that patients with PAH who require intensive care have a significant risk of mortality, and certain echocardiographic parameters (notably those related to right ventricular function and atrial strain) are associated with poorer outcomes.