Prognostic Factors for Survival in Pulmonary Hypertension Due to Left Heart Disease

Yamabe, Sayuri; Dohi, Yoshihiro; Fujisaki, Seiichiro; Higashi, Akifumi; Kinoshita, Hiroki; Sada, Yoshiharu; Hidaka, Takayuki; Kurisu, Satoshi; Yamamoto, Hideya; Kihara, Yasuki

doi:10.1253/circj.cj-15-0708

Cited by 19 publications

(19 citation statements)

References 34 publications

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“…One of the possible mechanisms might be the involvement of cardio-renal-anemia syndrome in pulmonary hypertension as reported previously [10]. Yambe et al reported that NYHA classification, eGFR, and hemoglobin level were better than the hemodynamic indices as predictive factors for cardiac death in LHD-PH [11]. However, their analysis did not include PAC.…”

Section: Discussionmentioning

confidence: 96%

“…However, other studies have reported no difference between C-pcPH and I-pcPH in clinical outcome [14, 15]. Such discrepancies might be due to a small absolute value of DPG, which could easily be the cause of a measurement error [11]. However, the ESC guidelines have recently recommended the use of DPG, rather than TPG, for distinction of C-pcPH or I-pcPH (C-pcPH is defined as PVR > 3 Wood unit and/or DPG ≥ 7 mmHg) [5].…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease

Sugimoto¹,

Yoshihisa²,

Nakazato³

et al. 2016

PLoS ONE

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BackgroundAlthough 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.MethodsThe 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.ResultsThe 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).ConclusionPAC is useful in the prediction of cardiac event risk in LHD-PH patients.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease

Sugimoto¹,

Yoshihisa²,

Nakazato³

et al. 2016

PLoS ONE

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“…14 In this issue of the Journal a study by Yamabe et al, who investigated the factors prognostic of survival in patients with PH due to LHD. 15 Their study population comprised 243 patients who were diagnosed as having PH due to LHD after undergoing right heart catheterization. Multivariate analysis revealed several independent predictors of mortality: age, more severe New York Heart Association (NYHA) functional class, elevated NT-pro BNP, decreased estimated glomerular filtration rate (eGFR), and anemia.…”

Section: Disclosuresmentioning

confidence: 99%

The Roles of Classic and Current Prognostic Factors in Pulmonary Hypertension Due to Left Heart Disease

Hirashiki

Kondo

Murohara

2016

Circ J

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“…Yet, while haemodynamic variables, such as the mean right atrial pressure, proved to have independent prognostic ability in patients with pulmonary arterial hypertension (group I), they failed to predict mortality in subjects with pulmonary hypertension secondary to left heart diseases (group II) 21 .…”

Section: Discussionmentioning

confidence: 95%

Prognostic impact of invasive haemodynamic measurements in combination with clinical and echocardiographic characteristics on two-year clinical outcomes of patients undergoing transcatheter aortic valve implantation

Franzone¹,

O’Sullivan²,

Stortecky³

et al. 2017

EuroIntervention

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Aims: The aim of the study was to evaluate the prognostic utility of right heart catheterisation (RHC)-derived measures among patients undergoing transcatheter aortic valve implantation (TAVI). and December 2012 and undergoing preoperative RHC were analysed. The relationship between haemodynamic parameters and survival was evaluated with Cox proportional hazards models. At two-year follow-up, 118 patients had died (25.1%). At multivariable analysis, diabetes (hazard ratio [HR] 1.95, 95% confidence interval [CI]: 1.28-2.96, p=0.001), transapical access (HR 1.66, 95% CI: 1.07-2.56, p=0.02), and moderate or severe mitral regurgitation (HR 1.55, 95% CI: 1.00-2.39, p=0.04) were independent predictors of two-year mortality, whereas no correlation between RHC-derived measures and mortality was found. Furthermore, the addition of haemodynamic variables did not significantly improve the prognostic power of a model incorporating clinical and echocardiographic data p=0.47). Methods and results:Conclusions: On the basis of a comprehensive clinical and echocardiographic evaluation, RHC performed prior to TAVI does not add incremental prognostic value. KEYWORDS• aortic stenosis • risk stratification • transcatheter aortic valve implantation (TAVI)

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Prognostic Factors for Survival in Pulmonary Hypertension Due to Left Heart Disease

Cited by 19 publications

References 34 publications

Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease

Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease

The Roles of Classic and Current Prognostic Factors in Pulmonary Hypertension Due to Left Heart Disease

Prognostic impact of invasive haemodynamic measurements in combination with clinical and echocardiographic characteristics on two-year clinical outcomes of patients undergoing transcatheter aortic valve implantation

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