Author + information
- Evan Brittain,
- Meredith Pugh,
- Lisa Wheeler,
- Ivan Robbins,
- James Loyd,
- John Newman,
- Eric Austin and
- Anna Hemnes
Right ventricular (RV) function is a major determinant of outcome in patients with pulmonary arterial hypertension (PAH). Little is known about the response of RV function or its hemodynamic determinants to PAH–specific therapy. We hypothesized that RV stroke work index (RVSWI) and pulmonary capacitance (PC) would increase after treatment and that prostanoids would have a stronger effect than oral therapy.
We reviewed hemodynamic and health data on 58 patients from a prospective database and analyzed changes in hemodynamics between diagnostic and first repeat catheterization after initiation of therapy for PAH.
RVSWI and PC increased significantly after therapy (p = 0.007 and 0.005, respectively). Improvement in RV function was limited to patients treated with prostanoid–only therapy (p = 0.04; Figure); no improvement was found in patients treated with oral therapy (p = 0.25). Patients with the poorest baseline RV function (lowest tertile) had the greatest improvement post–therapy (p = 0.005 and < 0.001 vs. middle and highest tertiles). The major determinant of RVSWI was change in stroke volume (rs = 0.54, p < 0.001), indicating RVSWI is an accurate reflection of RV function.
RV function improves after therapy with regimens including prostanoids. Patients with the least compensated RV function at diagnosis may derive the most benefit from therapy. Larger studies are needed to determine whether changes in RVSWI after therapy are associated with outcomes.
Special Session North, Room 120
Monday, March 11, 2013, 8:30 a.m.–8:45 a.m.
Session Title: Young Investigator Awards Competition: Clinical Investigations, Congenital Heart Disease, and Cardiovascular Surgery
Abstract Category: Clinical Investigations, Congenital Heart Disease, Cardiac Surgery
Presentation Number: 408–6
- 2013 American College of Cardiology Foundation