Prognostic Value of Various Hemodynamic Parameters in Pulmonary Hypertension

pp. 139-143

Abstract

Background: Pulmonary hypertension (PH) is associated with high morbidity and mortality and its prognosis is determined by the right ventricular function and right ventricular-pulmonary artery coupling. Several hemodynamic parameters have been proposed to better characterize the risk for adverse disease progression.

Objective: The aim of this study was to determine the predictive ability of various hemodynamic parameters that can be calculated during RHC to predict serious events.

Methods: In this retrospective multicenter and descriptive cohort study of patients with PH, hemodynamic variables values were divided as high or low risk based on the 2022 European guidelines, or mean or median values in our population

Results: A total of 324 patients with PH were included; mean age was 61.5 years and 69% were women; 62.1 % of the patients were in Group 1 and 19.2 % in Group 3. In a median (IQR) follow-up of 23(14-44) months, the event rate (death or hospitalization for heart failure) was 60.6% and all-cause mortality was 24.5%. The cut-off values associated with risk for the different hemodynamic variables were: cardiac index (CI) 2.72 L/min/m², systolic volume index (SVI) 33.1 ml/m², pulmonary vascular resistance (PVR) 6 Wood units (WU), pulmonary artery pulsatility index (PAPI) 3.76, right ventricle systolic work index (RVSWI) 11.6 g.m/m², and pulmonary arterial compliance 1.84 mL/mm Hg. Elevated PVR was associated with a higher rate of composite events, while high-risk CI, SVI, PVR, and compliance were associated with higher mortality at follow-up.

Conclusions: While CI and SVI are adequate predictors of risk, PVR and compliance demonstrate similar or even better risk prediction (...)

How to cite this article:

Alcántara Costas Martingano P, Vanegas T, Vargas Mieles P, Silva Croome N, Besmalinovich  E, Sorasio G, y cols. Prognostic Value of Various Hemodynamic Parameters in Pulmonary Hypertension. Rev Argent Cardiol 2024;92:139-43. http://dx.doi.org/10.7775/rac.v92.i1.20745