Echocardiographic Assessment of Pulmonary Artery Systolic Pressure and Outcomes in Ambulatory Heart Failure Patients

• Published in: Journal of the American Heart Association 2014-02, Vol.3 (1), p.e000363-n/a
• Main Authors: Kalogeropoulos, Andreas P., Siwamogsatham, Sarawut, Hayek, Salim, Li, Song, Deka, Anjan, Marti, Catherine N., Georgiopoulou, Vasiliki V., Butler, Javed
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ambulatory Care; Arterial Pressure; Atrial Function, Right; Atrial Pressure; Disease-Free Survival; echocardiography; Echocardiography, Doppler, Color; Familial Primary Pulmonary Hypertension; Female; heart failure; Heart Failure - diagnostic imaging; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Heart Transplantation; Heart-Assist Devices; Hospitalization; Humans; Hypertension, Pulmonary - diagnostic imaging; Hypertension, Pulmonary - mortality; Hypertension, Pulmonary - physiopathology; Hypertension, Pulmonary - therapy; Kaplan-Meier Estimate; Male; Middle Aged; mortality; Original Research; outcomes; Predictive Value of Tests; Proportional Hazards Models; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - physiopathology; pulmonary hypertension; Risk Factors; Stroke Volume; Systole; Time Factors; Ventricular Function, Left; Ventricular Function, Right
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.113.000363

Background Pulmonary hypertension (PH) in patients with heart failure (HF) is associated with worse outcomes and is rapidly being recognized as a therapeutic target. To facilitate pragmatic research efforts, data regarding the prognostic importance of noninvasively assessed pulmonary artery systolic pressure (PASP) in stable ambulatory patients with HF are needed. Methods and Results We examined the association between echocardiographic PASP and outcomes in 417 outpatients with HF (age, 54±13 years; 60.7% men; 50.4% whites; 24.9% with preserved ejection fraction). Median PASP was 36 mm Hg (interquartile range [IQR]: 29, 46). After a median follow‐up of 2.6 years (IQR: 1.7, 3.9) there were 72 major events (57 deaths; 9 urgent heart transplants; and 6 ventricular assist device implantations) and 431 hospitalizations for HF. In models adjusting for clinical risk factors and therapy, a 10‐mm Hg higher PASP was associated with 37% higher risk (95% CI: 18, 59; P