Echocardiographic Pulmonary Arterial Capacitance Predicts PH Mortality
Echocardiographic assessment of pulmonary arterial capacitance predicts mortality in patients with pulmonary hypertension (PH), according to a new study.
“We have demonstrated that echocardiographic surrogate for pulmonary arterial capacitance is a readily available echocardiographic marker that independently predicts mortality in pulmonary hypertension,” the researchers wrote, “and have provided clinically relevant ranges by which to risk-stratify patients and predict mortality.”
The retrospective study included 302 patients with PH at a comprehensive PH care center. The cumulative follow-up time was 858 patient-years.
Researchers reviewed charts from 2004 to 2018 to identify patients who underwent right heart catheterization within 2 months of an echocardiogram, extracted standard functional and biochemical prognostic markers, and searched for links with all-cause mortality.
All-cause mortality was associated with several variables, according to the researchers, including echocardiographic assessment of pulmonary arterial capacitance (hazard ratio [HR] 0.68), right heart catheterization pulmonary arterial capacitance (HR 0.68), echocardiographic pulmonary vascular resistance (HR 1.29), 6-minute walk distance (HR 0.43), and B-type natriuretic peptide (HR 1.29).
Multivariable-adjusted analysis showed that echocardiographic assessment of pulmonary arterial capacitance predicted all-cause mortality independently of age, gender, and comorbidities.
“There was a graded and stepwise association between low (<0.15 cm/mmHg), medium (0.15-0.25 cm/mmHg), and high (>0.25 cm/mmHg) tertiles of echocardiographic surrogate for pulmonary arterial capacitance and all-cause mortality,” the researchers concluded.
Papolos A, Tison GH, Mayfield J, Vasti E, DeMarco T. Echocardiographic assessment of pulmonary arterial capacitance predicts mortality in pulmonary hypertension. J Cardiol. Published online November 4, 2020. https://doi.org/10.1016/j.jjcc.2020.10.006