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Right ventricular outflow tract hypertrophy assessment as a diagnostic stratification tool in patients with pulmonary hypertension
Session:
Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker:
Catarina Oliveira
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.3 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Catarina Simões De Oliveira; Tiago Rodrigues; Nelson Cunha; Pedro Silvério António; Sara Couto Pereira; Joana Brito; Beatriz Valente Silva; Rui Plácido; João Agostinho; Tatiana Guimarães; Inês Aguiar-Ricardo; Joana Rigueira; Susana Martins; Nuno Lousada; Fausto j. Pinto; Ana Almeida
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction: The right ventricle (RV) is a complex structure whose geometry changes in the presence of pulmonary hypertension (PH). The impact of chronic RV pressure overload on its remodeling process and the relationship with the hemodynamic phenotype and clinical group of PH is not stablished. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Purpose: To evaluate the relationship between the RV outflow tract (RVOT) thickness and the hemodynamic phenotype and clinical characteristics of PH patients. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: Longitudinal observational study of consecutive patients with diagnosis of PH, based on hemodynamic criteria, and submitted to a high­resolution CT pulmonary angiography. PH was defined as precapillary [pulmonary arterial wedge pressure (PAWP) of 15 mmHg or lower], isolated pos­capillary [PAWP higher than 15 mmHg and diastolic pressure gradient (DPG) less than 7 mmHg] or combined pos­capillary (PAWP higher than 15 mmHg and DPG of 7 or more). The thickness, in millimeters, of the RVOT was measured in sagittal planes. The values obtained were compared with patient`s hemodynamic profile, clinical classification (Nice 2013), WHO functional class and the presence of signs of heart failure (HF) at presentation.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: 78 patients were included, 69.2% females, with mean age 67 years old (IQR:26). 76% had precapillary PH, 21% combined post­capillary PH and 4% isolated post­capillary PH. Based on the clinical classification, 50% of the patients belonged to group 4, 28% to group 1, 11% to group 3 and 6% to group 2. The RVOT thickness did not differ significantly according to the WHO functional class, presence of right­sided HF signs at presentation or with hemodynamic classification. However, considering the clinical classification, the RVOT thickness varied significantly between groups (group 1: 6,1±1,7mm; group 4: 5,6±1,2mm; group 3: 5,2±1,2mm; group 2: 3,5±0,3mm, p=0,002). By analysis of variance, it was verified that this variation was due to the lower thickness of the RVOT in group 2 when compared with the other groups (versus group 1, 3 and 4; respectively p<0,001, p=0,004 and p<0,001). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: The thickness of RVOT varies between clinical groups of PH, being significantly lower in patients from the group 2 patients. Based on this result we concluded that this parameter is useful in the diagnostic and etiological evaluation of patients with PH.</span></span></p> <p> </p>
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