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Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction
Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain. We retrospectively enroll...
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| Published in: | Journal of the American Heart Association 2024-05, Vol.13 (9), p.e032412-e032412 |
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| container_title | Journal of the American Heart Association |
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| creator | Zhou, Zeming Gu, Yuanrui Tian, Lili Zheng, Hong Li, Shiguo |
| description | Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain.
We retrospectively enrolled 103 patients with pretricuspid shunts with high total pulmonary resistance >4.5 Wood units (estimated pulmonary vascular resistance ≥3 Wood units). During a mean±SD follow-up of 20.95±24.84 months, 32 patients developed postoperative persistent PH after shunt correction. We identified 3 significant predictors of postoperative persistent PH, including mean pulmonary artery pressure after inhaled oxygen ≥40.5 mm Hg (odds ratio [OR], 7.78 [95% CI, 2.02-30.03]; |
| doi_str_mv | 10.1161/JAHA.123.032412 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_b7b4a6d9f81d495d82ede5d02e7120fb</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_b7b4a6d9f81d495d82ede5d02e7120fb</doaj_id><sourcerecordid>3043073894</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-d9d7d5ce22a36d2f8790a8017e93c6b441c5d244d5ca515b68fe7942b5b24c673</originalsourceid><addsrcrecordid>eNpVkk1P3DAQhqOqVUGUc2-Vj73s4q_E9qmKtpQFoYJE26vl2JPFKIlTO0FC_fM4LEXgi-2Zd54Z2W9RfCZ4TUhFTi7qbb0mlK0xo5zQd8UhxVyslJL4_avzQXGc0h3Oq6KClepjccBkxRRj9LD49x3uoQtjD8OEzODQH9N5ZyYfBhRaZNDP0IddNP1yu4aYfJoW6fXc9WEw8QFtH0aIOZaWEj-g2s1dzkeYordzGr1DN7fzMCVUtxNEtAkxgl0afCo-tKZLcPy8HxW_f5z-2mxXl1dn55v6cmU54dPKKSdcaYFSwypHWykUNhITAYrZquGc2NJRzrPGlKRsKtmCUJw2ZUO5rQQ7Ks73XBfMnR6j7_PcOhivnwIh7rSJk7cd6EY03FROtZI4rkonKTgoHaYgCMVtk1nf9qxxbnpwNr9FNN0b6NvM4G_1LtxrQohQUspM-PpMiOHvDGnSvU8Wus4MEOakGeYMCyYVz9KTvdTGkFKE9qUPwXqxgF4soLMF9N4CueLL6_Fe9P8_nD0CmXKu6g</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3043073894</pqid></control><display><type>article</type><title>Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction</title><source>Wiley-Blackwell Open Access Collection</source><source>PubMed Central</source><creator>Zhou, Zeming ; Gu, Yuanrui ; Tian, Lili ; Zheng, Hong ; Li, Shiguo</creator><creatorcontrib>Zhou, Zeming ; Gu, Yuanrui ; Tian, Lili ; Zheng, Hong ; Li, Shiguo</creatorcontrib><description>Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain.
We retrospectively enrolled 103 patients with pretricuspid shunts with high total pulmonary resistance >4.5 Wood units (estimated pulmonary vascular resistance ≥3 Wood units). During a mean±SD follow-up of 20.95±24.84 months, 32 patients developed postoperative persistent PH after shunt correction. We identified 3 significant predictors of postoperative persistent PH, including mean pulmonary artery pressure after inhaled oxygen ≥40.5 mm Hg (odds ratio [OR], 7.78 [95% CI, 2.02-30.03];
<0.01), total pulmonary resistance after inhaled oxygen ≥6.5 Wood units (estimated pulmonary vascular resistance ≥5 Wood units; OR, 12.23 [95% CI, 2.12-70.46];
<0.01), and artery oxygen saturation at rest <95% (OR, 3.34 [95% CI, 1.07-10.44];
=0.04). We established the prediction model with the C-statistics of 0.85 (95% CI, 0.77-0.93;
<0.01), and the C-statistic was 0.83 (95% CI, 0.80-0.86) after bootstrapping 10 000 times with a good performance of the nomogram calibration curve for predicting persistent PH.
Our study presents a multivariable risk stratification model for persistent PH after shunt correction in adults with pretricuspid shunts. This model, based on 3 hemodynamic predictors after inhaled oxygen, may assist in identifying individuals at higher risk of persistent PH after shunt correction.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.123.032412</identifier><identifier>PMID: 38639332</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>heart defects ; Original Research ; predict ; pulmonary hypertension ; shunts ; surgical repair</subject><ispartof>Journal of the American Heart Association, 2024-05, Vol.13 (9), p.e032412-e032412</ispartof><rights>2024 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c414t-d9d7d5ce22a36d2f8790a8017e93c6b441c5d244d5ca515b68fe7942b5b24c673</cites><orcidid>0009-0005-7578-2128 ; 0000-0001-8572-1218 ; 0000-0002-8750-3078 ; 0000-0002-1321-0571</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179888/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179888/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38639332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Zeming</creatorcontrib><creatorcontrib>Gu, Yuanrui</creatorcontrib><creatorcontrib>Tian, Lili</creatorcontrib><creatorcontrib>Zheng, Hong</creatorcontrib><creatorcontrib>Li, Shiguo</creatorcontrib><title>Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain.
We retrospectively enrolled 103 patients with pretricuspid shunts with high total pulmonary resistance >4.5 Wood units (estimated pulmonary vascular resistance ≥3 Wood units). During a mean±SD follow-up of 20.95±24.84 months, 32 patients developed postoperative persistent PH after shunt correction. We identified 3 significant predictors of postoperative persistent PH, including mean pulmonary artery pressure after inhaled oxygen ≥40.5 mm Hg (odds ratio [OR], 7.78 [95% CI, 2.02-30.03];
<0.01), total pulmonary resistance after inhaled oxygen ≥6.5 Wood units (estimated pulmonary vascular resistance ≥5 Wood units; OR, 12.23 [95% CI, 2.12-70.46];
<0.01), and artery oxygen saturation at rest <95% (OR, 3.34 [95% CI, 1.07-10.44];
=0.04). We established the prediction model with the C-statistics of 0.85 (95% CI, 0.77-0.93;
<0.01), and the C-statistic was 0.83 (95% CI, 0.80-0.86) after bootstrapping 10 000 times with a good performance of the nomogram calibration curve for predicting persistent PH.
Our study presents a multivariable risk stratification model for persistent PH after shunt correction in adults with pretricuspid shunts. This model, based on 3 hemodynamic predictors after inhaled oxygen, may assist in identifying individuals at higher risk of persistent PH after shunt correction.</description><subject>heart defects</subject><subject>Original Research</subject><subject>predict</subject><subject>pulmonary hypertension</subject><subject>shunts</subject><subject>surgical repair</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkk1P3DAQhqOqVUGUc2-Vj73s4q_E9qmKtpQFoYJE26vl2JPFKIlTO0FC_fM4LEXgi-2Zd54Z2W9RfCZ4TUhFTi7qbb0mlK0xo5zQd8UhxVyslJL4_avzQXGc0h3Oq6KClepjccBkxRRj9LD49x3uoQtjD8OEzODQH9N5ZyYfBhRaZNDP0IddNP1yu4aYfJoW6fXc9WEw8QFtH0aIOZaWEj-g2s1dzkeYordzGr1DN7fzMCVUtxNEtAkxgl0afCo-tKZLcPy8HxW_f5z-2mxXl1dn55v6cmU54dPKKSdcaYFSwypHWykUNhITAYrZquGc2NJRzrPGlKRsKtmCUJw2ZUO5rQQ7Ks73XBfMnR6j7_PcOhivnwIh7rSJk7cd6EY03FROtZI4rkonKTgoHaYgCMVtk1nf9qxxbnpwNr9FNN0b6NvM4G_1LtxrQohQUspM-PpMiOHvDGnSvU8Wus4MEOakGeYMCyYVz9KTvdTGkFKE9qUPwXqxgF4soLMF9N4CueLL6_Fe9P8_nD0CmXKu6g</recordid><startdate>20240507</startdate><enddate>20240507</enddate><creator>Zhou, Zeming</creator><creator>Gu, Yuanrui</creator><creator>Tian, Lili</creator><creator>Zheng, Hong</creator><creator>Li, Shiguo</creator><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0009-0005-7578-2128</orcidid><orcidid>https://orcid.org/0000-0001-8572-1218</orcidid><orcidid>https://orcid.org/0000-0002-8750-3078</orcidid><orcidid>https://orcid.org/0000-0002-1321-0571</orcidid></search><sort><creationdate>20240507</creationdate><title>Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction</title><author>Zhou, Zeming ; Gu, Yuanrui ; Tian, Lili ; Zheng, Hong ; Li, Shiguo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-d9d7d5ce22a36d2f8790a8017e93c6b441c5d244d5ca515b68fe7942b5b24c673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>heart defects</topic><topic>Original Research</topic><topic>predict</topic><topic>pulmonary hypertension</topic><topic>shunts</topic><topic>surgical repair</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Zeming</creatorcontrib><creatorcontrib>Gu, Yuanrui</creatorcontrib><creatorcontrib>Tian, Lili</creatorcontrib><creatorcontrib>Zheng, Hong</creatorcontrib><creatorcontrib>Li, Shiguo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Zeming</au><au>Gu, Yuanrui</au><au>Tian, Lili</au><au>Zheng, Hong</au><au>Li, Shiguo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2024-05-07</date><risdate>2024</risdate><volume>13</volume><issue>9</issue><spage>e032412</spage><epage>e032412</epage><pages>e032412-e032412</pages><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain.
We retrospectively enrolled 103 patients with pretricuspid shunts with high total pulmonary resistance >4.5 Wood units (estimated pulmonary vascular resistance ≥3 Wood units). During a mean±SD follow-up of 20.95±24.84 months, 32 patients developed postoperative persistent PH after shunt correction. We identified 3 significant predictors of postoperative persistent PH, including mean pulmonary artery pressure after inhaled oxygen ≥40.5 mm Hg (odds ratio [OR], 7.78 [95% CI, 2.02-30.03];
<0.01), total pulmonary resistance after inhaled oxygen ≥6.5 Wood units (estimated pulmonary vascular resistance ≥5 Wood units; OR, 12.23 [95% CI, 2.12-70.46];
<0.01), and artery oxygen saturation at rest <95% (OR, 3.34 [95% CI, 1.07-10.44];
=0.04). We established the prediction model with the C-statistics of 0.85 (95% CI, 0.77-0.93;
<0.01), and the C-statistic was 0.83 (95% CI, 0.80-0.86) after bootstrapping 10 000 times with a good performance of the nomogram calibration curve for predicting persistent PH.
Our study presents a multivariable risk stratification model for persistent PH after shunt correction in adults with pretricuspid shunts. This model, based on 3 hemodynamic predictors after inhaled oxygen, may assist in identifying individuals at higher risk of persistent PH after shunt correction.</abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>38639332</pmid><doi>10.1161/JAHA.123.032412</doi><orcidid>https://orcid.org/0009-0005-7578-2128</orcidid><orcidid>https://orcid.org/0000-0001-8572-1218</orcidid><orcidid>https://orcid.org/0000-0002-8750-3078</orcidid><orcidid>https://orcid.org/0000-0002-1321-0571</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | heart defects Original Research predict pulmonary hypertension shunts surgical repair |
| title | Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction |
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