Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension
Abstract To assess the long‐term prognostic value of cardiac catheterization and acute vasodilator testing (AVT) with inhaled iloprost in children with idiopathic pulmonary arterial hypertension (IPAH). Data on 81 consecutive children with IPAH referred to our center who underwent cardiac catheteriz...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12169 |
| _version_ | 1797975754653302784 |
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| author | Chen Zhang Konstantinos Dimopoulos Qiangqiang Li Hong Gu |
| author_facet | Chen Zhang Konstantinos Dimopoulos Qiangqiang Li Hong Gu |
| author_sort | Chen Zhang |
| collection | DOAJ |
| description | Abstract To assess the long‐term prognostic value of cardiac catheterization and acute vasodilator testing (AVT) with inhaled iloprost in children with idiopathic pulmonary arterial hypertension (IPAH). Data on 81 consecutive children with IPAH referred to our center who underwent cardiac catheterization and AVT between June 2008 and August 2019 were collected. The correlation between the invasive hemodynamic data and transplant‐free survival was analyzed. Twenty‐four patients died and 1 underwent lung transplantation during a median follow‐up of 3.8 years, with a 5‐year transplant‐free survival rate of 64.9%. Univariate analysis showed that predictors associated with improved survival included a lower pulmonary vascular resistance index (PVRI), PVRI/systemic vascular resistance index (SVRI), mean pulmonary arterial pressure (mPAP)/mean systemic arterial pressure, mean right atrial pressure, and a higher cardiac index (CI), mixed systemic venous oxygen saturations (SvO2), and acute vasodilator response (AVR) according to the Barst criteria (decrease in mPAP and PVRI/SVRI ratio of >20% without a decrease in CI). In multivariate Cox regression analysis, Barst AVR and SvO2 were independently related to transplant‐free survival. Multiple hemodynamic variables from cardiac catheterization and AVT with inhaled iloprost have important prognostic value for long‐term survival in children with IPAH, of which pulmonary vasoreactivity defined by the Barst criteria and SvO2 are independent prognostic factors. |
| first_indexed | 2024-04-11T04:40:27Z |
| format | Article |
| id | doaj.art-a8b78227fab649e18c76935a0ac77b45 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-11T04:40:27Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-a8b78227fab649e18c76935a0ac77b452022-12-28T07:32:41ZengWileyPulmonary Circulation2045-89402022-10-01124n/an/a10.1002/pul2.12169Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertensionChen Zhang0Konstantinos Dimopoulos1Qiangqiang Li2Hong Gu3Department of Pediatric Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing ChinaAdult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital London UKDepartment of Pediatric Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing ChinaDepartment of Pediatric Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing ChinaAbstract To assess the long‐term prognostic value of cardiac catheterization and acute vasodilator testing (AVT) with inhaled iloprost in children with idiopathic pulmonary arterial hypertension (IPAH). Data on 81 consecutive children with IPAH referred to our center who underwent cardiac catheterization and AVT between June 2008 and August 2019 were collected. The correlation between the invasive hemodynamic data and transplant‐free survival was analyzed. Twenty‐four patients died and 1 underwent lung transplantation during a median follow‐up of 3.8 years, with a 5‐year transplant‐free survival rate of 64.9%. Univariate analysis showed that predictors associated with improved survival included a lower pulmonary vascular resistance index (PVRI), PVRI/systemic vascular resistance index (SVRI), mean pulmonary arterial pressure (mPAP)/mean systemic arterial pressure, mean right atrial pressure, and a higher cardiac index (CI), mixed systemic venous oxygen saturations (SvO2), and acute vasodilator response (AVR) according to the Barst criteria (decrease in mPAP and PVRI/SVRI ratio of >20% without a decrease in CI). In multivariate Cox regression analysis, Barst AVR and SvO2 were independently related to transplant‐free survival. Multiple hemodynamic variables from cardiac catheterization and AVT with inhaled iloprost have important prognostic value for long‐term survival in children with IPAH, of which pulmonary vasoreactivity defined by the Barst criteria and SvO2 are independent prognostic factors.https://doi.org/10.1002/pul2.12169acute vasodilator testingheart catheterizationiloprostprognosispulmonary arterial hypertension |
| spellingShingle | Chen Zhang Konstantinos Dimopoulos Qiangqiang Li Hong Gu Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension Pulmonary Circulation acute vasodilator testing heart catheterization iloprost prognosis pulmonary arterial hypertension |
| title | Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension |
| title_full | Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension |
| title_fullStr | Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension |
| title_full_unstemmed | Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension |
| title_short | Long‐term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension |
| title_sort | long term prognostic value of cardiac catheterization and acute vasodilator testing with inhaled iloprost in pediatric idiopathic pulmonary arterial hypertension |
| topic | acute vasodilator testing heart catheterization iloprost prognosis pulmonary arterial hypertension |
| url | https://doi.org/10.1002/pul2.12169 |
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