Author + information
- Frances Mao,
- Priyanka T. Bhattacharya,
- Gregory S. Troutman,
- Jonathan N. Menachem,
- Monique Tanna,
- Arieh L. Fox,
- Edo Y. Birati,
- Paul Forfia,
- Anjali Vaidya and
- Jeremy Mazurek
Background: Pulmonary hypertension (PH) due to heart failure with preserved ejection fraction (HFpEF) is a leading cause of PH. Within this population, the diastolic pressure gradient (DPG) distinguishes those with combined post- and pre-capillary PH (DPG ≥7 mm Hg; CpcPH), and isolated post-capillary PH (DPG <7 mm Hg; IpcPH). Furthermore, prior work has shown pulmonary arterial compliance (PAC; calculated as ratio of stroke volume to PA pulse pressure) to be lower in CpcPH, and prognostic of survival in this population. In this study, we describe and compare the right ventricular outflow tract velocity time integral (RVOT-VTI) to pulmonary artery systolic pressure (PASP) ratio, a novel non-invasive metric of PAC in CpcPH vs. IpcPH.
Methods: We retrospectively identified patients with HFpEF-PH, and identified those with CpcPH and IpcPH, as defined above. Using a t-test, we assessed the difference in non-invasively estimated PAC using RVOT-VTI/PASP, between the two groups.
Results: Eighty-one patients were included in this study, of which 50 had IpcPH and 31 had CpcPH. Mean RVOT-VTI/PASP was 0.48±0.32 cm/mm Hg in the IpcPH group, and 0.24±0.11 cm/mm Hg in the CpcPH group, respectively (p<0.0001).
Conclusion: RVOT-VTI/PASP, is a novel non-invasive estimate of PAC, and is significantly lower in CpcPH, highlighting PH that is “out of proportion” to the degree of left heart failure. Further study is needed to investigate the effect of therapy on this novel metric as well as prognostic value in this population.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Imaging Pulmonary Vascular Disease Plus the Impact of Congenital Heart Disease
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1100-007
- 2017 American College of Cardiology Foundation