Effect of Group 2 Pulmonary Hypertension Subgroups on Outcomes: Impact of the Updated Definition of Pulmonary Hypertension
Effect of Group 2 Pulmonary Hypertension Subgroups on Outcomes: Impact of the Updated Definition of Pulmonary Hypertension
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DOI：
10.1016/j.hlc.2021.10.002
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发表时间：
2022-03-16
影响因子：
2.6
通讯作者：
Ozdemir, Nihal
中科院分区：
文献类型：
--
作者：
Bayram, Zubeyde;Dogan, Cem;Ozdemir, Nihal
背景：肺动脉高压(PH)是终末期心力衰竭(ESHF)的常见并发症，且与死亡率增加有关。PH的定义最近已从平均肺动脉压(PAPm)=25 mm Hg改为PAPm>；20 mm Hg。由于这一变化，没有数据评估第二组PH亚组的结果。本研究的目的是确定更新的第二组PH亚组对预后的影响，以及评估亚组的临床、超声心动图和血流动力学特征，并确定预测ESHF患者PH的因素。主要结果被定义为左心室辅助装置(LVAD)植入、紧急心脏移植(HT)或死亡。结果在503.5天的中位随访期内，联合的毛细血管前、后PH(CPC-PH)较单纯毛细血管后PH(IPC-PH)的风险更大(风险比[HR]，1.57；95%可信区间[CI]，1.29~1.91；P
Background Pulmonary hypertension (PH) is a common complication of end-stage heart failure (ESHF) and associated with increased mortality. The definition of PH has recently been changed from a mean pulmonary arterial pressure (PAPm) >= 25 mmHg to a PAPm >20 mmHg. Since this change, there are no data evaluating group 2 PH subgroups on outcomes. The purpose of this study was to determine the impact of updated group 2 PH subgroups on outcomes, as well as to evaluate the clinical, echocardiographic, and haemodynamic characteristics of subgroups, and determine predictors of PH in patients with ESHF.Method A total of 416 patients with ESHF with left ventricular ejection fraction (LVEF) 20 mmHg. Primary outcome was defined as left ventricular assist device (LVAD) implantation, urgent heart transplantation (HT), or death. Secondary outcome was defined as LVAD implantation and HT.Results Over a median follow-up of 503.5 days, combined pre- and postcapillary PH (Cpc-PH) displayed greater risk of primary outcome than those with isolated postcapillary (Ipc-PH) (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.29-1.91; p