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Predictors of pulmonary hypertension in patients with end-stage heart failure.

Abstract

Pulmonary hypertension (PH) is associated with a greater mortality rate in patients with heart failure (HF) and it is a risk factor for right ventricular failure after heart transplantation. This study was designed to explore risk factors for PH development in patients with advanced heart failure and left ventricular dysfunction. In a retrospective observational study of 419 patients evaluated for heart transplantation due to end stage HF, different variables were analyzed to find predictors of PH (defined as a mean pulmonary pressure >25 mmHg), reactive PH (defined as a transpulmonary gradient >12 mmHg) and severe PH (defined as a mean pulmonary pressure >40 mmHg and/or pulmonary vascular ressistance >3 WU) using a multivariate stepwise logistic regression analysis. Prevalence of PH, out of proportion and severe PH was 62.2%, 23.8%, and 18.8% respectively. The presence of moderate-severe mitral regurgitation [2.1 (1.2-3.7); P=0.006], moderate-severe tricuspid regurgitation [OR 2.9 (1.3-6.4); P=0.005] and a duration of disease >3 years [OR 1.7 (1.1-2.7); P=0.03] were independent risk factors associated with PH. Moreover, the presence of a moderate-severe mitral regurgitation and a duration of disease greater than 3 years, were independent predictors of out of proportion and severe PH.

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  • Publisher Full Text
  • Authors

    Torres-Macho J, Delgado-Jiménez JF, Sanz-Salvo J, González-Mansilla A, Sánchez-Sánchez V, Gámez-Díez S, Escribano-Subías P, Sáenz de la Calzada C

    Institution

    Division of Heart Failure and Transplant Unit, Department of Cardiology, Hospital Doce de Octubre, Madrid, Spain. jtorresmacho@gmail.com

    Source

    Congestive heart failure (Greenwich, Conn.) 18:4 pg 212-6

    MeSH

    Disease Progression
    Female
    Heart Failure, Systolic
    Humans
    Hypertension, Pulmonary
    Logistic Models
    Male
    Middle Aged
    Mitral Valve Insufficiency
    Prognosis
    Retrospective Studies
    Risk Factors
    Systole
    Tricuspid Valve Insufficiency
    Ventricular Dysfunction, Left

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22809259