Comparison of Baseline Predictors of Prognosis in Pulmonary Arterial Hypertension in Patients Surviving ≤2 Years and Those Surviving ≥5 Years After Baseline Right-Sided Cardiac Catheterization

Batal, Omar; Khatib, Omar F.; Dweik, Raed A.; Hammel, Jeffrey; McCarthy, Kevin; Minai, Omar A.

doi:10.1016/j.amjcard.2012.01.366

Cited by 29 publications

(32 citation statements)

References 29 publications

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“…Such attempts have included single variables as well as composite prediction equations. 2,9,10 We have previously shown that HRR1 could accurately predict hospitali- Figure 5. Patients with heart rate recovery after 1 minute of rest (HRR1) of <16 had worse World Health Organization functional class (WHO FC), higher B-type natriuretic peptide (BNP), and shorter 6-minute walk distance (6MWD) and were more likely to have a pericardial effusion on Doppler echocardiography.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] To identify groups of patients that may be at an increased risk and may benefit from more aggressive therapy, several studies have attempted to establish predictors of poor prognosis in a more comprehensive manner using several variables. 2,9,10 Although these are of value, their ease of use in everyday practice in the community setting is unclear.…”

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confidence: 99%

“…9 Recent publications have reported on the presence of autonomic dysfunction and its possible association with survival in patients with PAH. [11][12][13] Heart rate recovery (HRR) refers to the reduction in heart rate with rest after graded exercise.…”

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confidence: 99%

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Heart Rate Recovery is an Important Predictor of Outcomes in Patients with Connective Tissue Disease–Associated Pulmonary Hypertension

et al. 2015

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Reduced heart rate recovery (HRR) after exercise is associated with increased mortality in cardiac and pulmonary diseases. We sought to evaluate the association between HRR after the 6-minute walk test (6MWT) and outcomes in patients with connective tissue diseaseassociated pulmonary hypertension (CTD-PH). Data were obtained by review of the medical records. HRR was defined as the difference in heart rate at the end of the 6MWT and after 1 minute (HRR1), 2 minutes (HRR2), and 3 minutes (HRR3) of rest. All patients with pulmonary hypertension and a diagnosis of systemic sclerosis, systemic lupus erythematosus, or mixed connective tissue disease who underwent the 6MWT between August 1, 2009, and October 30, 2011, were included (n = 66). By Kaplan-Meier analysis, HRR1, HRR2, and HRR3 at different cutoff points were all good predictors, with HRR1 of <16 being the best predictor of time to clinical worsening (log-rank P < 0.0001), hospitalization (log-rank P = 0.0001), and survival (log-rank P < 0.003). By proportional hazards regression, patients with HRR1 of <16 were at increased risk of clinical worsening (hazard ratio [

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Heart Rate Recovery is an Important Predictor of Outcomes in Patients with Connective Tissue Disease–Associated Pulmonary Hypertension

et al. 2015

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“…The interaction between PH, right ventricular failure, and kidney function has not been well studied. Several factors lead to the development and worsening of PH, and kidney dysfunction and volume overload are common occurrences in clinical practice that can lead to increased pulmonary artery pressure (PAP) (3,4). This decline in kidney function could be transiently related to hemodynamic changes during the treatment of volume overload associated with PH (5).…”

Section: Introductionmentioning

confidence: 99%

“…An important and frequently underappreciated cause of PH is left-sided heart failure with a preserved ejection fraction (EF; with or without underlying diastolic dysfunction), and these conditions are often noted in CKD (10,11). In patients with PH, elevated mean right atrial pressure (RAP), decreased cardiac index, and elevated mean PAP (mPAP) were associated with a poor prognosis (3,12).…”

Section: Introductionmentioning

confidence: 99%

Presence and Outcomes of Kidney Disease in Patients with Pulmonary Hypertension

Navaneethan

Wehbe

Heresi³

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Pulmonary hypertension is associated with higher mortality rates. The associations of nondialysis-dependent CKD and all-cause mortality in patients with pulmonary hypertension were studied.Design, setting, participants, & measurements The study population included those patients who underwent right heart catheterization for confirmation of pulmonary hypertension between 1996 and January 2011. Pulmonary hypertension was defined as the presence of mean pulmonary artery pressure$25 mmHg at rest measured by right heart catheterization. CKD was defined as the presence of two measurements of eGFR,60 ml/min per 1.73 m 2 90 days apart. The risk factors associated with CKD as well as the association between CKD and death in those patients with pulmonary hypertension using logistic regression and Cox proportional hazard models were examined.Results Of 1088 patients with pulmonary hypertension, 388 (36%) patients had CKD: 340 patients had stage 3 CKD, and 48 (4%) patients had stage 4 CKD. In the multivariable analysis, older age, higher hemoglobin, and higher mean right atrial pressures were independently associated with CKD. During a median follow-up of 3.2 years (interquartile range=1.5-5.6 years), 559 patients died. After adjusting for relevant covariates, presence of stage 3 CKD (hazard ratio, 1.37; 95% confidence interval, 1.14 to 1.66) and stage 4 CKD (hazard ratio, 2.69; 95% confidence interval, 1.88 to 3.86) was associated with all-cause mortality in those patients with pulmonary hypertension. When eGFR was examined as a continuous measure, a 5 ml/min per 1.73 m 2 lower eGFR was associated with a 5% (95% confidence interval, 1.03 to 1.07) higher hazard for death. This higher risk with CKD was similar irrespective of demographics, left ventricular function, and pulmonary capillary wedge pressure. ConclusionIn a clinical population referred for right heart catheterization, presence of CKD was associated with higher all-cause mortality in those patients with pulmonary hypertension. Mechanisms that may underlie these associations warrant additional studies.

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Six-Minute Walk Test as a Predictor of Diagnosis, Disease Severity, and Clinical Outcomes in Scleroderma-Associated Pulmonary Hypertension: The DIBOSA Study

Gadre

Ghattas

Xiao

et al. 2017

Lung

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Comparison of Baseline Predictors of Prognosis in Pulmonary Arterial Hypertension in Patients Surviving ≤2 Years and Those Surviving ≥5 Years After Baseline Right-Sided Cardiac Catheterization

Cited by 29 publications

References 29 publications

Heart Rate Recovery is an Important Predictor of Outcomes in Patients with Connective Tissue Disease–Associated Pulmonary Hypertension

Heart Rate Recovery is an Important Predictor of Outcomes in Patients with Connective Tissue Disease–Associated Pulmonary Hypertension

Presence and Outcomes of Kidney Disease in Patients with Pulmonary Hypertension

Six-Minute Walk Test as a Predictor of Diagnosis, Disease Severity, and Clinical Outcomes in Scleroderma-Associated Pulmonary Hypertension: The DIBOSA Study

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