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Four-strata risk-assessment tool for pulmonary hypertension: can we associate it with haemodynamic parameters?
Session:
Sessão de Posters 06 - Hipertensão Pulmonar
Speaker:
João Fernandes Pedro
Congress:
CPC 2024
Topic:
I. Hypertension
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
João Fernandes Pedro; Ana Beatriz Garcia; Catarina Oliveira; Ana Margarida Martins; Miguel Azaredo Raposo; Catarina Gregório; João Fonseca; Tatiana Guimarães; Susana Martins; Nuno Lousada; Fausto J. Pinto; Rui Plácido
Abstract
<p style="text-align:justify"><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Pulmonary hypertension (PH) is a severe pulmonary vascular disease associated with significant morbidity and mortality. The disease can be idiopathic, hereditary (group 1), associated with left heart disease (group 2), lung disease and/or hypoxia (group 3), pulmonary artery obstructions (group 4) or related with multifactorial mechanisms (group 5). Recent European Society of Cardiology (ESC) guidelines proposed a new comprehensive risk-assessment tool which classifies patients with PH having low, intermediate-low risk, intermediate-high risk or high risk in order to better stratify mortality risk. The four-strata risk-assessment tool is based on World Health Organization-Functional Capacity (WHO-FC), six-minute walk distance (6MWD) and NT-proBNP. However, the correlation between this new classification method and haemodynamic measures is not yet established.</span></span></span></p> <p><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Objective</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To study the association between the four-strata risk assessment tool and right heart catheterization (RHC) hemodynamic parameters.</span></span></span></p> <p><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">We conducted a retrospective analysis of PH group 1 and 4 patients that underwent RHC in the last two years in a tertiary hospital. Information about demographics, WHO-FC, 6MWD, blood biochemistry and data from echocardiography and RHC were collected. In an exploratory analysis, four-strata risk and RHC parameters were compared.</span></span></span></p> <p><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">A total of 79 patients were evaluated (median age 68 years, 34% men and 66% female). Of these 53% had group 1 PH and 47% group 4 PH. There were 34 patients (43%) classified as low risk, 28 patients (35%) as intermediate-low risk and 2 (3%) as intermediate-high risk. Four-strata classification during follow-up showed a significant statistic association with pulmonary artery systolic pressure (p=0,013), pulmonary mean arterial pressure (p=0,013), cardiac output (p=0,06) and pulmonary vascular resistance by Fick equation (p= 0,002) and thermodilution (p=0,013).</span></span></span></p> <p><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Four-strata risk assessment tool score has a statistically significant association with clinically relevant RHC parameters. As a non-invasive evaluation, it should be performed during follow-up to obtain a more sensitive risk stratification and therefore optimize patient care, eventually leading to therapy adjustments.</span></span></span></p>
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