Right and left heart dysfunction predict mortality in pulmonary hypertension

Grönlund, Christer (author): Umeå universitet,Institutionen för strålningsvetenskaper

Gonzalez, Manuel (author): Umeå universitet,Avdelningen för medicin,Heart Centre

(creator_code:org_t)

2015-06-19
2017
English.
In: Clinical Physiology and Functional Imaging. - : Wiley-Blackwell. - 1475-0961 .- 1475-097X. ; 37:1, s. 45-51

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Abstract Subject headings

In pulmonary hypertension (PH), the right heart dysfunction is a strong predictor of adverse clinical outcome, while the role of the left heart is not fully determined. The aim of this study was to identify predictors of mortality in precapillary PH including measures of both right and left heart function. We studied 34 patients (mean age 64 ± 13, range 31-82 years, 24 females) with precapillary PH, all of whom underwent detailed Doppler echocardiographic examination of the right and left heart function using conventional and speckle-tracking echocardiography. Patients were followed up for up to 8 years (mean 4·2 ± 1·9 years). At follow-up, 16 patients survived. Left ventricular (LV) filling time (P = 0·007), pulmonary artery acceleration time (P = 0·009), right atrial pressure (RAP) (P<0·001) and tricuspid regurgitation (TR) severity (P = 0·007) were worse in the deceased group. RV global longitudinal strain (GLS) (P = 0·001), RAP (P≤0·001), LV filling time (P<0·001) and TR severity (P<0·001) were the most accurate predictors, having the largest AUC (>0·65) and carried the highest risk for mortality (P<0·001 for all). The strongest predictors of mortality in precapillary PH indirectly reflect both left and right heart dysfunction including atrial structure and function disturbances. While an interaction pattern is observed, it needs to be confirmed in a larger cohort.

By the author/editor: Henein, Michael ...; Grönlund, Christ ...; Tossavainen, Eri ...; Söderberg, Stefa ...; Gonzalez, Manuel; Lindqvist, Per

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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