High haemoglobin levels at the time of occlusion predict worse outcome for patients with patent ductus arteriosus and pulmonary hypertension.

Autor:	Kishi K; Division of Cardiology, Department of Paediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan., Jarutach J; Division of Cardiology, Department of Paediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand., Ooi YK; Paediatric Department, Cardiology Unit, Serdang Hospital, 43000 Serdang, Selangor, Malaysia., Wong NL; Department of Cardiology, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Kuching 93596, Sarawak, Malaysia., Che Mood M; Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia., Kandhavello G; Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia., Alwi M; Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia., Leong MC; Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia.
Jazyk:	angličtina
Zdroj:	Cardiology in the young [Cardiol Young] 2023 Aug; Vol. 33 (8), pp. 1359-1366. Date of Electronic Publication: 2022 Aug 11.
DOI:	10.1017/S104795112200244X
Abstrakt:	Introduction: Current guidelines discourage shunt closure in patients with pulmonary vascular resistance index >8 Wood units x m 2 . The study examined the long-term outcome of patients over 15 years old, with pulmonary vascular resistance index >8 Wood units x m 2 and patent ductus arteriosus. Materials and Methods: This was a multi-institutional, retrospective study involving all consecutive patients (>15 years old) with patent ductus arteriosus and severe pulmonary hypertension. Patients who had patent ductus arteriosus closure were divided into the Good (no death or hospital admissions due to worsening pulmonary hypertension) and the Poor Outcome groups and these groups were compared. Results: Thirty-seven patients [male: 9 (24.3%); mean age: 30.49 ± 9.56 years; median follow-up: 3 (IQR: 1.5,10) years] were included from four centers. Twenty-two patients who underwent patent ductus arteriosus closure, 15 (71.4%) had good outcomes while 7 (28.6%) had poor outcomes. Pulmonary vascular resistance index and pulmonary to systemic resistance ratio (Rp:Rs) were lower in the Good Outcome Group (14.35 ± 1.66 Wood units x m 2 vs. 20.07 ± 2.44; p = 0.033 and 0.44 ± 0.16 vs. 1.08 ± 1.21; p = 0.042). Haemoglobin concentrations (<14.3 g/dL) were associated with good long-term outcomes in the Closed Group. Conclusions: Patients with patent ductus arteriosus with severe pulmonary hypertension have a dismal outcome with or without closure. High haemoglobin levels at the time of occlusion predict a worse outcome for patients with patent ductus arteriosus and pulmonary hypertension.
Databáze:	MEDLINE
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