Interaction between pulmonary hypertension and diastolic dysfunction in an elderly heart failure population

van Empel, Vanessa P. M. and Kaufmann, Beat A. and Bernheim, Alain M. and Goetschalckx, Kaatje and Min, Son Y. and Muzzarelli, Stefano and Pfisterer, Matthias E. and Kiencke, Stephanie and Maeder, Micha T. and Brunner-La Rocca, Hans-Peter. (2014) Interaction between pulmonary hypertension and diastolic dysfunction in an elderly heart failure population. Journal of cardiac failure, 20 (2). pp. 98-104.

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Official URL: https://edoc.unibas.ch/62163/

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BACKGROUND: Pulmonary hypertension due to left heart disease is very common. Our aim was to investigate the relationship of the severity of left ventricular diastolic dysfunction with precapillary and postcapillary pulmonary hypertension (PH) in an elderly heart failure (HF) population. METHODS AND RESULTS: A post hoc analysis of the Trial of Intensified Medical Therapy in Elderly Patients With Congestive Heart Failure data was done. Baseline transthoracic echocardiography was used to categorize diastolic function, estimate pulmonary artery pressure and pulmonary capillary wedge pressure, and calculate the transpulmonary pressure gradient (TPG). Among 392 HF patients, PH was present in 31% of patients with grade 1, in 37% of patients with grade 2, and in 65% of patients with grade 3 diastolic dysfunction; 54% of all HF patients with PH had a TPG <12 mm Hg, suggesting not only a postcapillary but also an additional precapillary component of PH. Survival was not related to the severity of diastolic dysfunction, but was worse in patients with PH (hazard ratio 1.63, 95% confidence interval 1.07-2.51; P = .024). CONCLUSIONS: Our data indicate that HF patients with even mild diastolic dysfunction often have PH. Echocardiographic assessment suggest that the presence of PH might not simply be due to increased PCWP, but in part due to a precapillary component.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Cardiovascular Molecular Imaging (Kaufmann)
UniBasel Contributors:Kaufmann, Beat
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Churchill Livingstone
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:28 Jul 2020 14:59
Deposited On:28 Jul 2020 14:59

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