Long-term follow-up in outpatients with mildly elevated pulmonary artery systolic pressure on echocardiography: a single-centre retrospective cohort study in Shanghai, China.

Autor:	Weng Z; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Zhang L; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Lin D; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Yang L; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China.; Department of Cardiology, Zhongshan Hospital Fudan University Minhang Meilong, Shanghai, China., Jin Q; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Long Y; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Li W; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China.; Department of Echocardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China., Pan W; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China peden@sina.com shu.xianhong@zs-hospital.sh.cn.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Shu X; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China peden@sina.com shu.xianhong@zs-hospital.sh.cn.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China.; Department of Echocardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China., Zhou D; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China., Ge J; Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.; National Clinical Research Center for Interventional Medicine, Shanghai, Shanghai, China.; Shanghai Institute of Cardiovascular Diseases, Shanghai, Shanghai, China.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jul 18; Vol. 14 (7), pp. e086516. Date of Electronic Publication: 2024 Jul 18.
DOI:	10.1136/bmjopen-2024-086516
Abstrakt:	Objective: To investigate the correlation between mildly elevated pulmonary artery systolic pressure (PASP) on echocardiography and mortality, as well as long-term changes in PASP. Design: Retrospective cohort study. Setting: Shanghai, China, a single centre. Participants: A total of 910 patients were enrolled in this study. From January to June 2016, 1869 patients underwent echocardiography at the Zhongshan Hospital affiliated with Fudan University. Patients with malignant tumours, previous heart or other solid organ transplantation, previous or scheduled ventricular assist device implantation, severe kidney dysfunction (uraemia and patients on dialysis) and a life expectancy of less than 1 year for any medical condition were excluded. Interventions: No interventions were done. Primary and Secondary Outcome Measures: The predictors of death in patients with mild echocardiographic pulmonary hypertension were analysed using univariate and multivariate Cox regression analyses. Paired t-tests were used to calculate changes in the PASP values at baseline and follow-up for different patient groups. Results: The 5-year survival of patients was 93.2%. Patients were grouped according to whether they had combined organic heart disease (OHD). The PASP value was an independent predictor of all-cause mortality in patients with OHD, with each 1 mm Hg increase associated with an HR of 1.02 (95% CI: 1.01-1.03, p=0.038) but not in patients without OHD. Of the total, 46% (419/910) of the patients with 5-6 years of echocardiography were investigated for changes in the PASP value. We found significant PASP reduction in patients without OHD (42.8±2.4 mm Hg vs 39.3±8.2 mm Hg, p<0.001), but no significant change was observed for patients with OHD (42.8±2.5 mm Hg vs 42.4±8.8 mm Hg, p=0.339). Conclusions: The PASP was associated with all-cause mortality in patients with OHD and mildly elevated PASP compared with patients without OHD. After 5-6 years of follow-up, the PASP on echocardiography was not further elevated in patients without OHD. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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