Severity of precapillary pulmonary hypertension: Predictive factor
Background and objectives: Patients with pulmonary arterial hypertension (PAH) require risk assessments for prognosis and appropriate therapy. These assessments need to be improved by incorporating clinical and laboratory data such as the analysis of the right ventricle. We aim to establish echocard...
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| Format: | Article |
| Language: | English |
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Elsevier España
2023-12-01
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| Series: | Pulmonology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531043721002269 |
| _version_ | 1797399084350308352 |
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| author | J.A. de Barros G. Sant’Ana G. Martins L. Madlum C. Scremim R. Petterle D. Escuissato E. Lima |
| author_facet | J.A. de Barros G. Sant’Ana G. Martins L. Madlum C. Scremim R. Petterle D. Escuissato E. Lima |
| author_sort | J.A. de Barros |
| collection | DOAJ |
| description | Background and objectives: Patients with pulmonary arterial hypertension (PAH) require risk assessments for prognosis and appropriate therapy. These assessments need to be improved by incorporating clinical and laboratory data such as the analysis of the right ventricle. We aim to establish echocardiographic morphometric data of the right ventricle and its relationship with the left ventricle, to estimate the hemodynamic severity of precapillary pulmonary hypertension (PHprecapillary). Methods: This cohort, prospective, observational, and cross-sectional study included 41 consecutive patients with PHprecapillary using echocardiographic study and cardiac catheterization. Results: Patients’ mean age was 44.0±16.4 years, and 37 were women (90.2%). Idiopathic PAH was diagnosed in 18 patients (43.9%). The World Health Organization/New York Association functional class was III or IV in 31 patients (75.6%). The ratio of the right to left ventricles (RV/LV) echocardiographic diastolic diameters was associated with pulmonary arterial pressures in cardiac catheterization, with the best cutoff per receiver operating characteristic curve being 0.8 for systolic pressure (sensitivity 90.0%, specificity 78.3%, area under the curve [AUC] 0.882) and mean pressure (sensitivity 60.0%, specificity 95.7%, AUC 0.823). Spearman's correlation (R) of RV/LV echocardiographic ratio and the hemodynamic variables was significant for systolic pressure (R = 0.7015, p < 0.0001), mean pressure (R = 0.6332, p < 0.0001), transpulmonary pressure gradient (R = 0.6524, p < 0.0001), pulmonary vascular resistance (R = 0.6076, p = 0.0021), and pulmonary vascular resistance index (R = 0.6229, p = 0.0014). Conclusion: The ratio of RV/LV echocardiographic diastolic diameters contribute to the estimates the hemodynamic severity of precapillary pulmonary hypertension. The best cutoff for this assessment was RV/LV of 0.8. |
| first_indexed | 2024-03-09T01:34:22Z |
| format | Article |
| id | doaj.art-9147577258b649f89cf324fd5ea96bac |
| institution | Directory Open Access Journal |
| issn | 2531-0437 |
| language | English |
| last_indexed | 2024-03-09T01:34:22Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Pulmonology |
| spelling | doaj.art-9147577258b649f89cf324fd5ea96bac2023-12-09T06:07:27ZengElsevier EspañaPulmonology2531-04372023-12-0129S25S35Severity of precapillary pulmonary hypertension: Predictive factorJ.A. de Barros0G. Sant’Ana1G. Martins2L. Madlum3C. Scremim4R. Petterle5D. Escuissato6E. Lima7Federal University of Paraná, Department of Internal Medicine, Cardiology and Pneumology Unit, Curitiba, Brazil; Corresponding author at: General Carneiro Street, 180 (10th floor), Curitiba, Brazil. ZIP Code 80060-150.Federal University of Paraná, Department of Internal Medicine, Cardiology and Pneumology Unit, Curitiba, BrazilFederal University of Paraná, Department of Internal Medicine, Cardiology and Pneumology Unit, Curitiba, BrazilFederal University of Paraná, Department of Internal Medicine, Cardiology and Pneumology Unit, Curitiba, BrazilFederal University of Paraná, Department of Internal Medicine, Cardiology and Pneumology Unit, Curitiba, BrazilFederal University of Paraná, Department of Integrative Medicine, Curitiba, BrazilFederal University of Paraná, Department of Internal Medicine, Radiology Unit, Curitiba, BrazilFederal University of Paraná, Department of Internal Medicine, Cardiology and Pneumology Unit, Curitiba, BrazilBackground and objectives: Patients with pulmonary arterial hypertension (PAH) require risk assessments for prognosis and appropriate therapy. These assessments need to be improved by incorporating clinical and laboratory data such as the analysis of the right ventricle. We aim to establish echocardiographic morphometric data of the right ventricle and its relationship with the left ventricle, to estimate the hemodynamic severity of precapillary pulmonary hypertension (PHprecapillary). Methods: This cohort, prospective, observational, and cross-sectional study included 41 consecutive patients with PHprecapillary using echocardiographic study and cardiac catheterization. Results: Patients’ mean age was 44.0±16.4 years, and 37 were women (90.2%). Idiopathic PAH was diagnosed in 18 patients (43.9%). The World Health Organization/New York Association functional class was III or IV in 31 patients (75.6%). The ratio of the right to left ventricles (RV/LV) echocardiographic diastolic diameters was associated with pulmonary arterial pressures in cardiac catheterization, with the best cutoff per receiver operating characteristic curve being 0.8 for systolic pressure (sensitivity 90.0%, specificity 78.3%, area under the curve [AUC] 0.882) and mean pressure (sensitivity 60.0%, specificity 95.7%, AUC 0.823). Spearman's correlation (R) of RV/LV echocardiographic ratio and the hemodynamic variables was significant for systolic pressure (R = 0.7015, p < 0.0001), mean pressure (R = 0.6332, p < 0.0001), transpulmonary pressure gradient (R = 0.6524, p < 0.0001), pulmonary vascular resistance (R = 0.6076, p = 0.0021), and pulmonary vascular resistance index (R = 0.6229, p = 0.0014). Conclusion: The ratio of RV/LV echocardiographic diastolic diameters contribute to the estimates the hemodynamic severity of precapillary pulmonary hypertension. The best cutoff for this assessment was RV/LV of 0.8.http://www.sciencedirect.com/science/article/pii/S2531043721002269Pulmonary hypertensionEchocardiographyRight ventricleCardiac catheterizationHemodynamics |
| spellingShingle | J.A. de Barros G. Sant’Ana G. Martins L. Madlum C. Scremim R. Petterle D. Escuissato E. Lima Severity of precapillary pulmonary hypertension: Predictive factor Pulmonology Pulmonary hypertension Echocardiography Right ventricle Cardiac catheterization Hemodynamics |
| title | Severity of precapillary pulmonary hypertension: Predictive factor |
| title_full | Severity of precapillary pulmonary hypertension: Predictive factor |
| title_fullStr | Severity of precapillary pulmonary hypertension: Predictive factor |
| title_full_unstemmed | Severity of precapillary pulmonary hypertension: Predictive factor |
| title_short | Severity of precapillary pulmonary hypertension: Predictive factor |
| title_sort | severity of precapillary pulmonary hypertension predictive factor |
| topic | Pulmonary hypertension Echocardiography Right ventricle Cardiac catheterization Hemodynamics |
| url | http://www.sciencedirect.com/science/article/pii/S2531043721002269 |
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