Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease.
Although pulmonary hypertension due to left heart disease (LHD-PH) accounts for the largest proportion of pulmonary hypertension, few reports on the epidemiological analysis of LHD-PH exist. Recently, pulmonary arterial capacitance (PAC) has attracted attention as a possible factor of right ventricu...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5119730?pdf=render |
| _version_ | 1818127924510851072 |
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| author | Koichi Sugimoto Akiomi Yoshihisa Kazuhiko Nakazato Yuichiro Jin Satoshi Suzuki Tetsuro Yokokawa Tomofumi Misaka Takayoshi Yamaki Hiroyuki Kunii Hitoshi Suzuki Shu-Ichi Saitoh Yasuchika Takeishi |
| author_facet | Koichi Sugimoto Akiomi Yoshihisa Kazuhiko Nakazato Yuichiro Jin Satoshi Suzuki Tetsuro Yokokawa Tomofumi Misaka Takayoshi Yamaki Hiroyuki Kunii Hitoshi Suzuki Shu-Ichi Saitoh Yasuchika Takeishi |
| author_sort | Koichi Sugimoto |
| collection | DOAJ |
| description | Although pulmonary hypertension due to left heart disease (LHD-PH) accounts for the largest proportion of pulmonary hypertension, few reports on the epidemiological analysis of LHD-PH exist. Recently, pulmonary arterial capacitance (PAC) has attracted attention as a possible factor of right ventricular afterload along with pulmonary vascular resistance. We therefore investigated the clinical significance of PAC in LHD-PH.The subject consisted of 252 LHD-PH patients (145 men, mean age 63.4 ± 14.7 years) diagnosed by right heart catheterization. PAC was estimated by the ratio between stroke volume and pulmonary arterial pulse pressure. Patients were classified into four groups according to the PAC (1st quartile was 0.74 to 1.76 ml/mmHg, the 2nd quartile 1.77 to 2.53 ml/mmHg, the 3rd quartile 2.54 to 3.59 ml/mmHg, and the 4th quartile 3.61 to 12.14 ml/mmHg). The end-points were defined as rehospitalization due to worsening heart failure and/or cardiac death. The Cox proportional hazard regression model was used to determine what variables were associated with cardiac events.The patients in the 1st quartile had the lowest cardiac index and stroke volume index, and the highest mean pulmonary arterial pressure, mean pulmonary capillary wedge pressure, and pulmonary vascular resistance compared with the 2nd, 3rd, and 4th quartiles. Fifty-four patients experienced cardiac events during the follow-up period (median 943 days). The event-free rate of the 1st quartile was significantly lower than that of the 3rd and 4th quartiles (66.7% vs 82.5% [3rd quartile], P = 0.008; and 92.1% [4th quartile], P < 0.001). The Cox hazard analysis revealed that PAC was significantly associated with cardiac events (HR 0.556, 95% CI 0.424-0.730, P < 0.001).PAC is useful in the prediction of cardiac event risk in LHD-PH patients. |
| first_indexed | 2024-12-11T07:25:05Z |
| format | Article |
| id | doaj.art-136f9a54b6ab41ba8ba96d3f1993d802 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T07:25:05Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-136f9a54b6ab41ba8ba96d3f1993d8022022-12-22T01:15:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011111e016560310.1371/journal.pone.0165603Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease.Koichi SugimotoAkiomi YoshihisaKazuhiko NakazatoYuichiro JinSatoshi SuzukiTetsuro YokokawaTomofumi MisakaTakayoshi YamakiHiroyuki KuniiHitoshi SuzukiShu-Ichi SaitohYasuchika TakeishiAlthough pulmonary hypertension due to left heart disease (LHD-PH) accounts for the largest proportion of pulmonary hypertension, few reports on the epidemiological analysis of LHD-PH exist. Recently, pulmonary arterial capacitance (PAC) has attracted attention as a possible factor of right ventricular afterload along with pulmonary vascular resistance. We therefore investigated the clinical significance of PAC in LHD-PH.The subject consisted of 252 LHD-PH patients (145 men, mean age 63.4 ± 14.7 years) diagnosed by right heart catheterization. PAC was estimated by the ratio between stroke volume and pulmonary arterial pulse pressure. Patients were classified into four groups according to the PAC (1st quartile was 0.74 to 1.76 ml/mmHg, the 2nd quartile 1.77 to 2.53 ml/mmHg, the 3rd quartile 2.54 to 3.59 ml/mmHg, and the 4th quartile 3.61 to 12.14 ml/mmHg). The end-points were defined as rehospitalization due to worsening heart failure and/or cardiac death. The Cox proportional hazard regression model was used to determine what variables were associated with cardiac events.The patients in the 1st quartile had the lowest cardiac index and stroke volume index, and the highest mean pulmonary arterial pressure, mean pulmonary capillary wedge pressure, and pulmonary vascular resistance compared with the 2nd, 3rd, and 4th quartiles. Fifty-four patients experienced cardiac events during the follow-up period (median 943 days). The event-free rate of the 1st quartile was significantly lower than that of the 3rd and 4th quartiles (66.7% vs 82.5% [3rd quartile], P = 0.008; and 92.1% [4th quartile], P < 0.001). The Cox hazard analysis revealed that PAC was significantly associated with cardiac events (HR 0.556, 95% CI 0.424-0.730, P < 0.001).PAC is useful in the prediction of cardiac event risk in LHD-PH patients.http://europepmc.org/articles/PMC5119730?pdf=render |
| spellingShingle | Koichi Sugimoto Akiomi Yoshihisa Kazuhiko Nakazato Yuichiro Jin Satoshi Suzuki Tetsuro Yokokawa Tomofumi Misaka Takayoshi Yamaki Hiroyuki Kunii Hitoshi Suzuki Shu-Ichi Saitoh Yasuchika Takeishi Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease. PLoS ONE |
| title | Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease. |
| title_full | Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease. |
| title_fullStr | Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease. |
| title_full_unstemmed | Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease. |
| title_short | Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease. |
| title_sort | pulmonary arterial capacitance predicts cardiac events in pulmonary hypertension due to left heart disease |
| url | http://europepmc.org/articles/PMC5119730?pdf=render |
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