Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis
BackgroundPatients with left heart failure (LHF) are often associated with the development of pulmonary hypertension (PH) which leads to an increased risk of death. Recently, the diagnostic standard for PH has changed from mean pulmonary arterial pressure (mPAP) ≥25 mmHg to >20 mmHg. Nonethel...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.983803/full |
| _version_ | 1828154466202812416 |
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| author | Yangyi Lin Lingpin Pang Shian Huang Jieyan Shen Weifeng Wu Fangming Tang Weiqing Su Xiulong Zhu Jingzhi Sun Ruilin Quan Tao Yang Huijun Han Jianguo He |
| author_facet | Yangyi Lin Lingpin Pang Shian Huang Jieyan Shen Weifeng Wu Fangming Tang Weiqing Su Xiulong Zhu Jingzhi Sun Ruilin Quan Tao Yang Huijun Han Jianguo He |
| author_sort | Yangyi Lin |
| collection | DOAJ |
| description | BackgroundPatients with left heart failure (LHF) are often associated with the development of pulmonary hypertension (PH) which leads to an increased risk of death. Recently, the diagnostic standard for PH has changed from mean pulmonary arterial pressure (mPAP) ≥25 mmHg to >20 mmHg. Nonetheless, the effect of borderline PH (mPAP: 21–24 mmHg) on the prognosis of LHF patients is unclear. This study aimed to investigate the relationship between borderline PH and 3-year clinical outcomes in LHF patients.MethodsA retrospective analysis of a prospective cohort study was done for LHF patients who underwent right heart catheterization (RHC) between January 2013 and November 2016. The primary outcome was all-cause mortality; the secondary outcome was rehospitalization.ResultsAmong 344 patients, 62.5% were identified with a proportion of PH (mPAP ≥ 25), 10.8% with borderline PH (21–24), and 26.7% with non-PH (≤20), respectively. Multivariable Cox analysis revealed that borderline PH patients had a higher adjusted mortality risk (HR = 3.822; 95% CI: 1.043–13.999; p = 0.043) than non-PH patients. When mPAP was treated as a continuous variable, the hazard ratio for death increased progressively with increasing mPAP starting at 20 mmHg (HR = 1.006; 95% CI: 1.001–1.012). There was no statistically significant difference in adjusted rehospitalization between borderline PH and non-PH patients (HR = 1.599; 95% CI: 0.833–3.067; p = 0.158).ConclusionsBorderline PH is independently related to increased 3-year mortality in LHF patients. Future research is needed to evaluate whether more close monitoring, and managing with an intensifier improves clinical outcomes in borderline PH caused by LHF.Clinical trials registrationwww.clinicaltrials.gov NCT02164526. |
| first_indexed | 2024-04-11T22:40:23Z |
| format | Article |
| id | doaj.art-37a86fc245384875b55531ff8de29df1 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T22:40:23Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-37a86fc245384875b55531ff8de29df12022-12-22T03:59:00ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.983803983803Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysisYangyi Lin0Lingpin Pang1Shian Huang2Jieyan Shen3Weifeng Wu4Fangming Tang5Weiqing Su6Xiulong Zhu7Jingzhi Sun8Ruilin Quan9Tao Yang10Huijun Han11Jianguo He12Department of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaCardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaCardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaDepartment of Cardiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Cardiology, Nongken Central Hospital of Guangdong Province, Zhanjiang, ChinaDepartment of Cardiology, Lianjiang People's Hospital, Lianjiang, ChinaDepartment of Cardiology, People's Hospital of Gaozhou, Gaozhou, ChinaDepartment of Cardiology, Affiliated Hospital of Jining Medical University, Jining, ChinaDepartment of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaDepartment of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, ChinaDepartment of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaBackgroundPatients with left heart failure (LHF) are often associated with the development of pulmonary hypertension (PH) which leads to an increased risk of death. Recently, the diagnostic standard for PH has changed from mean pulmonary arterial pressure (mPAP) ≥25 mmHg to >20 mmHg. Nonetheless, the effect of borderline PH (mPAP: 21–24 mmHg) on the prognosis of LHF patients is unclear. This study aimed to investigate the relationship between borderline PH and 3-year clinical outcomes in LHF patients.MethodsA retrospective analysis of a prospective cohort study was done for LHF patients who underwent right heart catheterization (RHC) between January 2013 and November 2016. The primary outcome was all-cause mortality; the secondary outcome was rehospitalization.ResultsAmong 344 patients, 62.5% were identified with a proportion of PH (mPAP ≥ 25), 10.8% with borderline PH (21–24), and 26.7% with non-PH (≤20), respectively. Multivariable Cox analysis revealed that borderline PH patients had a higher adjusted mortality risk (HR = 3.822; 95% CI: 1.043–13.999; p = 0.043) than non-PH patients. When mPAP was treated as a continuous variable, the hazard ratio for death increased progressively with increasing mPAP starting at 20 mmHg (HR = 1.006; 95% CI: 1.001–1.012). There was no statistically significant difference in adjusted rehospitalization between borderline PH and non-PH patients (HR = 1.599; 95% CI: 0.833–3.067; p = 0.158).ConclusionsBorderline PH is independently related to increased 3-year mortality in LHF patients. Future research is needed to evaluate whether more close monitoring, and managing with an intensifier improves clinical outcomes in borderline PH caused by LHF.Clinical trials registrationwww.clinicaltrials.gov NCT02164526.https://www.frontiersin.org/articles/10.3389/fcvm.2022.983803/fullborderline pulmonary hypertensionleft heart failuremean pulmonary artery pressure (mPAP)mortalityright heart catheterization (RHC) |
| spellingShingle | Yangyi Lin Lingpin Pang Shian Huang Jieyan Shen Weifeng Wu Fangming Tang Weiqing Su Xiulong Zhu Jingzhi Sun Ruilin Quan Tao Yang Huijun Han Jianguo He Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis Frontiers in Cardiovascular Medicine borderline pulmonary hypertension left heart failure mean pulmonary artery pressure (mPAP) mortality right heart catheterization (RHC) |
| title | Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis |
| title_full | Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis |
| title_fullStr | Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis |
| title_full_unstemmed | Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis |
| title_short | Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis |
| title_sort | impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study a 3 year survivorship analysis |
| topic | borderline pulmonary hypertension left heart failure mean pulmonary artery pressure (mPAP) mortality right heart catheterization (RHC) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.983803/full |
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