News: Pulmonary artery stiffness may predict mortality risk in patients with mild pulmonary hypertension
In patients with mild pulmonary hypertension (PH), neither mean pulmonary artery pressure (mPAP) nor pulmonary vascular resistance (PVR) predicted mortality risks, whereas measures reflecting pulmonary artery stiffness and right-ventricular adaptation had independent prognostic value, a recent study published in Chest found.
Researchers analyzed data from an international meta-registry to evaluate the prognostic relevance of measures of right ventricular afterload and adaptation in patients with mild PH and across the full spectrum of PH. Mild PH was defined as mPAP greater than 20 mm Hg and less than 25 mm Hg, with pulmonary vascular resistance of three Wood units or less.
Mild PH was defined as mPAP greater than 20 mm Hg and less than 25 mm Hg, with pulmonary vascular resistance of three Wood units or less. Overall, 1,095 patients met this definition.
Researchers used baseline right-heart catheterization data to derive pulmonary artery compliance, arterial elastance, and stroke volume index. They then evaluated these against all-cause mortality with adjustment for clinical confounders.
The main outcome of the study was that mPAP and PVR did not predict mortality in patients with mild PH. In patients with mild PH, the risk for mortality was higher in those with arterial elastance > 0.36 mmHg/mL, in those with stroke volume index ≤ 31 mL/m2 , and in those with higher heart rates, even after adjusting for total pulmonary resistance.
In the full PH cohort, arterial elastance and stroke volume index remained significant independent of PVR and total pulmonary resistance. Pulmonary artery compliance remained significant, independent of PVR alone.
Editor’s note: To read the full study, click here. To read additional coverage from Medscape, click here.