Abstract
Background: In the setting of pulmonary hypertension (PH), pulmonary artery (PA) wedge pressure (PAWP) may contribute to right ventricular (RV) dysfunction because it elevates PA stiffness, relative to pulmonary vascular resistance. PA stiffness is expected to mainly depend on mean PA pressure (mPAP) and on a patient’s age and sex.
Aim: To test the hypothesis that PA stiffness was indeed increased in patients with high PAWP when potential confounding factors were taken into account.
Methods: This is a retrospective analysis of right heart catheterization results prospectively obtained at rest in 112 patients with post-capillary PH (pc-PH) and in 112 patients with pulmonary arterial hypertension (PAH) extracted from the French PAH Network registry (2006-2016) and matched for mPAP, and for age and sex. Stiffness was calculated as the PP/SV ratio, where PP is PA pulse pressure and SV is thermodilution stroke volume index.
Results: The matching procedure was efficient according to 3 criteria: mPAP (median (IQR) = 38 mmHg (33-48) in pc-PH vs 39 (33-46) mmHg in PAH), age (71 (64-79) vs 71 (64-78) years), and sex (72 F in each group) (each P=NS). As compared to PAH, pc-PH had similar PP (36 (26-43) vs 37 (30-47) mmHg) and heart rate (78 (63-88) vs 79 (66-88) bpm) (each P=NS), higher SV (37 (29-48) vs 32 (27-40) mL/m²) and lower stiffness (0.92 (0.64-1.39) vs 1.18 (0.83-1.62) mmHg/mL/m²) (each P<0.01).
Conclusion: Unexpectedly, PAWP decreased RV pulsatile loading (as reflected in PA stiffness) when potential confounding factors, including the prevailing mPAP, were taken into account. Our results deserve further independent confirmation.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA3315.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018