Echocardiographic predictors of low risk haemodynamic parameters in patients with pulmonary arterial hypertension

Abstract Background A periodic and multiparametric assessment of the risk profile patients with pulmonary arterial hypertension (PAH) is essential for a low-risk oriented treatment strategy. Haemodynamic parameters anyway cannot be collected at each scheduled outpatients clinic follow-up visit. Purpose To evaluate echocardiographic predictors haemodynamic in PAH. Methods Patients PAH referred to our centre were included up 31 December 2019. All underwent baseline demographic, clinical, WHO functional class, 6-minute walk test, brain natriuretic peptide (BNP), right cardiac catheterization evaluation. Through multivariate logistic regression analysis we low for: 1) BNP/right atrial pressure (RAP): NT-proBNP <300 ng/l/BNP <50 ng/l AND RAP <8 mmHg; 2) index (CI)/mixed venous oxygen saturation (SvO2): CI ≥2.5 l/min/m2 SvO2 >65%. Echocardiographic cut-offs chosen on basis ROC curves or Literature data. Results 1020 included. The two performed independently. 1. Independent BNP/RAP were: indexed area, mitral E/A ratio, dimension inspiratory collapse inferior vena cava left ventricular diastolic volume. We elaborated score utilizing these parameter cut-offs: an area 10.4–15 cm2/m2, ratio 0.8, indicative 0–5 vs 5–10 10–20 mmHg volume 32 ml/m2. has AUC: 0.62, specificity: 92%, sensitivity: 33%, negative predictive value: 70%, positive 69%. 2. CI/SvO2 S wave TDI, Tei index, tricuspid annular plane systolic excursion (TAPSE), severity regurgitation. TDI 9.5 cm/s, 0.4, TAPSE 1.7 cm, ml/m2 mild more than 0.70, 89%, 50%, 71%, 77%. Conclusion can used rule out presence values (indexed volume) (S TAPSE, regurgitation). FUNDunding Acknowledgement Type funding sources: None.