Author + information
- Sula Mazimba,
- Jamie Kennedy,
- Manu Mysore,
- Jeremy Mazurek,
- Andrew Mihalek,
- Lavone Smith,
- Eliany Mejia-Lopez,
- Timothy Welch,
- William C. Harding and
- Kenneth Bilchick
Background: In pulmonary hypertension (PH), interventricular coupling and ventricular-arterial coupling are important factors influencing cardiac efficiency. As a result, we hypothesized that the ratio of PA and SA pulse pressures (pulmonary-systemic pulse pressure ratio, or PS-PPR) in PH would be associated with adverse clinical outcomes in PH.
Methods: We evaluated the association between the PS-PPR and long-term clinical outcomes after adjustment for the Pulmonary Hypertension Connection (PHC) Risk Equation in the National Institutes of Health Primary Pulmonary Hypertension (PPH) Registry. Multivariable Cox proportional hazards regression and Kaplan-Meier survival analysis with the log-rank statistic were used in the analysis.
Results: Among 262 patients (mean age 37.5 ± 15.8 years, 62.2% female), the median PS-PPR was 1.04 (IQR 0.79-1.30). In the multivariable Cox model adjusted PHC risk, each unit increase in the PS-PPR was associated with more than a two-fold increase in mortality during follow-up (HR 2.25, 95% CI 1.50-3.36). Furthermore, patients with PS-PPR in the upper quintile (>1.44) had greater than twice the adjusted mortality rate of the remaining patients (HR 2.24, 95% CI 1.49-3.35), as shown in the Figure.
Conclusions: PS-PPR is independently associated with survival in group 1 PH even after adjustment for the PHC risk equation. These findings support further study of this novel index for guiding treatment and prognosis in group 1 PH.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in Pulmonary Arterial Hypertension
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1269-006
- 2017 American College of Cardiology Foundation