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Stroke volume index in Chronic Tromboembolic Pulmonary Hypertension: more information is power?
Session:
Posters (Sessão 5 - Écran 6) - Tromboembolismo pulmonar
Speaker:
João Mirinha Luz
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.7 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
João Mirinha Luz; Filipa Ferreira; Sofia Alegria; Ana Cláudia Vieira; Rita Calé Theotónio; Débora Repolho; Sílvia Vitorino; Alexandra Briosa; João Grade Santos; Bárbara Marques Ferreira; Mariana Martinho; Diogo Santos da Cunha; Nazar Ilchyshyn; Oliveira Baltazar; Ernesto Pereira; Hélder Pereira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Introduction and objective:</u></strong> The 2022 Pulmonary Hypertension (PH) guidelines brought us a new parameter to evaluate in right heart catheterization (RHC) – the stroke volume index (SVI). In addition to pulmonary artery saturation (SvO2), cardiac index (CI), right atrial pressure (RAP) and pulmonary vascular resistance (PVR), SVI is now a parameter to evaluate in PH patients regarding their risk stratification. We aimed to study the use of SVI in patients with chronic thromboembolic pulmonary hypertension (CTEPH) patients. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Methods:</u></strong> We have conducted a retrospective analysis of eighty-three (83) baseline RHC performed in our center in confirmed CTEPH patients from February 2010 until October 2022. To evaluate possible relationships between SVI and other RHC severity parameters, univariate linear regression methods were used. Parameters assessed by both thermodilution (TD) and Fick methods were analysed. We have also investigated if the use of SVI could change the prognostic evaluation of patients with CTEPH, by using the standard ESC/ERS 2022 guidelines cut-off values (<31, 31-38, >38) for risk stratification.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Results:</u></strong> Mean age at RHC was 62,6 years-old, and 68,7% of patients were female. 89,3% of the patients were naive of pulmonary vasodilatators. Mean SVI using TD was 28,71 ml/m2 [standard deviation (SD) 8,65], whereas mean SVI using Fick was 30,70 ml/m2 (SD 10,59). Our analysis showed that SVI by TD has a positive proportional relationship with CI (r=0,764, p<0,001) and SvO2 (r=0,510, p<0,001), and negative relationship with RAP (r=0,261, p=0,026) and RVP (r=0,795, p<0,001). SVI by Fick method showed similar results (table 1). Regarding prognostic evaluation, SVI by TD was associated with worse prognosis assessment in 18,1% of patients and with better assessement in 9,6%, whereas SVI by Fick was associated with worse assessement in 22,9% and better in 10,8%. Even though we have seen a tendency for worsening prognosis assessment using SVI, the difference between the worse-better changing prognosis was not significant statistically. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u>Conclusion:</u></strong> Our study showed that SVI is well related with older and extensively studied parameters in RHC, and it can add prognostic value in patients with CTEPH. More studies are needed to see if and how SVI can be related with diverse outcomes in this group of patients. </span></span></p>
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