Author + information
- George Giannakoulas,
- Sofia Mouratoglou,
- Vasileios Kamperidis,
- Georgia Pitsiou,
- Alexandros Kallifatidis,
- Stavros Hadjimiltiades and
- Haralampos Karvounis
Background: In patients with precapillary pulmonary hypertension (pPH) right ventricular pressure overload and interventricular septal shift result in a decreased left ventricular filling rate (LVFR). We hypothesized that the LVFR is of prognostic significance in patients with pPH.
Methods: Consecutive adult patients with pPH underwent six minute walk test (6MWT), assessment of NT-proBNP and echocardiographic evaluation in the same day. Four-chamber view was used for the estimation of mitral annulus diameter (MAd) and mitral peak early (E) wave. LVFR was calculated by the equation: LVFR = E wave*3.14*(MAd/2)2. Time from enrollment to first clinical event (death, hospitalization due to pPH, initiation of parenteral prostanoid therapy or atrial septostomy) was recorded.
Results: We included 42 patients with pPH (30 women, age 50.4±14.9 years). Over a median follow-up of 26.5 months (IQR 12.2-36.6 months), 23 patients had a clinical event. Univariate Cox proportional hazard analysis showed that 6MWT distance, NT-proBNP, WHO functional class and LVFR were significant predictors of prognosis. In order to further evaluate the additive prognostic value of LVFR, three different regression models were built using known predictors of survival (Table). Addition of LVFR to each one of the regression models resulted in a significant improvement in c-statistic suggestive of improved discrimination (Table).
Conclusion: Left ventricular filling pattern is a predictor of clinical failure in patients with pPH
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Predicting the Future: Observations and Discoveries From Registries and Databases
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1230-008
- 2017 American College of Cardiology Foundation