Author + information
: There is a scarcity of data examining hemodynamic correlates of renal function in pulmonary hypertension. Our objective was to analyze the strength of correlation between standard and novel hemodynamic indices, including pulmonary artery pulsatility index (PAPi) and right atrial to pulmonary capillary wedge pressure ratio (RA:PCWP), with renal function in pulmonary hypertension.
We retrospectively studied patients with pulmonary hypertension diagnosed by right heart catheterization (RHC) between 2007 and 2012 at Einstein Medical Center, Philadelphia. Patients with chronic kidney disease (GFR <90mL/min/1.73 m2) were excluded. Pulmonary artery pulse pressure (PAPP), RA:PCWP, PAPi (PAPP/RA) and standard RHC variables were studied.
The final cohort consisted of 172 patients, mean age was 59+13 yrs, 52% were men and mean pulmonary arterial pressure of 39+9 mm Hg. Sixty eight patients had worsening creatinine from the time of admission to the time of RHC. Patients with RA: PCWP of >0.86 had a significantly higher creatinine at RHC (2.2+1 vs. 1.7+1.7 mg/dL; p=0.01) and worsening creatinine (0.9+0.9 vs. 0.35+0.3 mg/dL; p=0.03) than patients with a RA:PCWP ratio of <0.86. Pearson correlation analysis between hemodynamic variables and worsening creatinine demonstrated:
Novel hemodynamic indices such as RA:PCWP and PAPP are better predictors of worsening renal failure than cardiac index in pulmonary hypertension.
|Hemodynamic Variable||Correlation Factor (r)||P value|
|Mean RA Pressure||0.25||0.04|
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pulmonary Hypertension: Physiology/Hemodynamics
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1164M-149
- 2013 American College of Cardiology Foundation