Pulmonary Hypertension: Predictors of Prognosis

Among the top study results presented during this session at the ACC 59th Annual Scientific Session, here are three focusing on pulmonary hypertension.

Researchers: Bersohn M, Shapiro S, Turner M, et al.

Purpose: In order to test the hypothesis “that a high resting heart rate [HR] and low systolic systemic blood pressure [SBP] would portend a worse prognosis in patients with pulmonary arterial hypertension [PAH], similar to patients with left ventricular dysfunction,” Bersohn explains, his research team analyzed “survival and freedom from all-cause hospitalization (hosp) in the Registry to Evaluate Early And Long-term PAH Disease Management (REVEAL), a large, ongoing, prospective, US-based observational study.”

Results: Bersohn says his team found that “baseline HR, SBP, and SBP/HR predicted survival and freedom from hospitalization during the first year of follow-up despite the similarity of some traditional prognostic indicators in PAH across Q.” He adds that vital sign parameters of HR greater than 95, SBP less than or equal to 102, or the ratio of SBP/HR less than or equal to 1.2 identified a high-risk group of patients that might benefit from more intensive treatment.”

Clinical and Echocardiographic Predictors of Pulmonary Hypertension in Young Adults: Results from CARDIA

Researchers: Kolli S, Chen R, Guglin M

Purpose: To define both clinical and echocardiographic predictors of pulmonary hypertension (PH) in young adults (age 12-35), as risk factors for PH are poorly understood.

Results: As measured by doppler pulmonary artery acceleration time, systolic and diastolic dysfunction were both statistically significant predictors of PH in young adults.

Vasodilator Response Predicts Long-Term Survival in Pulmonary Hypertension Regardless of Etiology

Researchers: Devendra G, Hart S, Agarwal S, et al.

Purpose: “Pulmonary vasodilator response is routinely assessed in patients with idiopathic pulmonary arterial hypertension, but its role in other types of pulmonary hypertension (PH) and its ability to predict clinical outcomes is unclear,” notes Devendra, adding that this study was conducted in order to examine “the impact of vasodilator responsiveness on survival in a diverse cohort of PH patients.”

Results: In every form of PH, it appears that vasodilator response is a critical method of risk stratification, a finding that leads Devendra to conclude that “vasodilator testing should be routinely performed in the initial evaluation regardless of PH etiology.”

Prognostic Value of Heart Rate and Systemic Blood Pressure in Pulmonary Arterial Hypertension