Chest
Original ResearchPulmonary Arterial HypertensionDeterminants of Right Ventricular Ejection Fraction in Pulmonary Arterial Hypertension
Section snippets
Study Design
We performed a cross-sectional analysis within a retrospective cohort study of consecutive adult patients with PAH who underwent initial evaluation at our center between January 1994 and June 2002. The study was approved by the Institutional Review Board.
Study Subjects
Details of the cohort have been published previously.7, 15, 16 The following criteria were required for inclusion in this study: (1) PAH that was idiopathic, familial, or associated with anorexigen use; (2) age > 16 years; (3) initial
Patient Characteristics
The cohort included 84 patients evaluated during the study period. Of those, 63 had equilibrium radionuclide angiography and right heart catheterization performed at baseline and constituted the study sample. Of these patients, 86% had radionuclide angiography performed within seven days of the right heart catheterization. Table 1 shows the characteristics of the study sample and the excluded patients. The mean age in the study sample was 41 ± 13 years, 79% of the patients were female, 78% were
Discussion
RV structure and function are important determinants of long-term survival in PAH; however, little is known about the factors present at the time of diagnosis that affect RV performance in this disease. The mean RVEF at baseline in our cohort was 30%, well below the lower limit of normal, and only three patients in the cohort had normal RVEF. Other studies of patients with PAH have shown similar results.5, 17 While RVEF was significantly associated with hemodynamics, there was substantial
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Sex Differences in Pulmonary Hypertension
2021, Clinics in Chest MedicineCitation Excerpt :Exogenous E2 was found to be associated with this increased RVEF in postmenopausal women taking hormone replacement therapy, while increased testosterone was associated with larger RV mass in men.78 Even in the face of increased circulating estrogen,43 male patients with PAH have been found to exhibit lower RVEF at baseline than female patients,80 and this appears to decline faster in men over time77 which may contribute to poor survival. In healthy men, higher DHEA-Sulfate levels were associated with higher RV stroke volume78 whereas lower DHEA-S levels are associated with PAH in men.43
Pulmonary Arterial Hypertension
2021, Sex Differences in Cardiac Diseases: Pathophysiology, Presentation, Diagnosis and ManagementTreatment Targets for Right Ventricular Dysfunction in Pulmonary Arterial Hypertension
2020, JACC: Basic to Translational Science
This study was supported by National Institutes of Health grants HL67771 and HL086719.
The authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).