Abstract
Background: The long-term prognosis for patients with pulmonary arterial hypertension (PAH) remains poor. Therefore, risk assessment is an important task of examination of PAH patients. In this regard, the search for simple prognostic markers in PAH is important.
Methods: We examined 110 pts with PH (mean age 43.4±14.8 yrs, M:F=45:65): 57 with idiopathic PAH, 8 with corrected congenital heart disease, 18 with scleroderma, 27 with inoperable CTEPH. 72 % pts had symptoms of III–IV FC WHO. ECHO, 6MWT, RHC and lung function testing had been performed.
Results: There were no differences between PAH and CTEPH groups in terms of hemodynamic parameters. But RV systolic dysfunction had more pronounced in patients with CTEPH as compared with idiopathic PAH: TAPSE 12.1±2.2 vs 15.3±3.1 and TASV 10.2± 3.1 cm/s vs 8.9 ± 2.1 cm/s; p< 0.05. Furthermore, we revealed correlations between ratio of end-diastolic size of the right and left ventricle (RV:LV) and PH function class (χ2=7.2, p<0.05). Patients with CTEPH had lower respiratory performance test in comparison with idiopathic PAH: FEV1 96.1±8.2 vs 91.3±9.1; p< 0.05; FEV1/FVC 82.1±7.5 vs 74.3±8.1, p< 0.05. Patients with RV:LV value less than 1.2 have a higher DLCO: 67.1±16.2 vs 54.8±12.1; p< 0.05.
Conclusions: RV:LV is simply an additional parameter for the assessment of RV function and prognosis of patients with PH (AUC 0.716; p=0.017). DLCO gives an additional information regarding prognosis of the patients (AUC 0.736; p=0.014). These simple, and non-invasive methods can be used not only for assessment of PH patient's severity and monitoring a their response to treatment, but also for the risk stratification.
- Copyright ©ERS 2015