| Popis: |
Background & aims: The suggested definition of exercise pulmonary hypertension is mean pulmonary arterial pressure>30mmHg and total pulmonary resistance>3WU at peak exercise. The aim of this study was to derive prognostic thresholds from pulmonary exercise hemodynamics in patients at risk for PH. Methods: From 2005 to 2017 patients with unexplained dyspnea and/or suspected pulmonary vascular disease were enrolled. Exercise RHC was performed in case of a resting mPAP Results: 211 patients were enrolled (68% female, age: 62±13yr, mPAP: 18±4mmHg). Median observational time was 4.2yrs with N=43 (20%) mortality events. MPAP/CO-slope turned out as an independent predictor of mortality, starting with a first significant prognostic cut-off at 5.98mmHg/L/min. Best cut-off was found at 7.47mmHg/L/min (HR: 2.95, 95%CI: 1.36-6.42; p=0.006). Patients with a high mPAP/CO-slope were older (73 [IQR 68-77] vs. 59 [IQR 50-69], p Conclusion: In patients at risk for PH, mPAP/CO-slope is an age- and sex-independent predictor of mortality. Subjects with high mPAP/CO-slope were significantly older, had more cardiopulmonary comorbidities, worse resting hemodynamics and higher NTproBNP. |
