Incident pulmonary hypertension in 13,448 cases investigated with repeat echocardiography: insight from the National Echo Database of Australia (NEDA)

Abstract Background We addressed the paucity of data describing characteristics and natural history incident pulmonary hypertension (PHT). Methods In this observational clinical cohort study, we examined 85,173 individuals undergoing routine echocardiography for heart disease without evidence PHT (according to estimated right ventricular systolic pressure, eRVSP <30 mmHg). Subsequent age sex-specific incidence were derived from repeat echocardiograms conducted a median 3.43 (interquartile range, IQR 1.49 6.55) years apart in 13,448 adults. Progressive severity with individual linkage all-cause mortality per stage: 30–39 mmHg (mild PHT), 40–49 (moderate PHT) ≥50 (severe PHT). Results A total 6,169 men (45.9%, mean 61.4±16.7 years) 7,279 women (60.8±16.9 no initial identified (first echocardiogram). Subsequently, 5,412 (40.2%,) developed (repeat echocardiogram) – comprising 4,125 (30.7%, 65.0±14.3 years), 928 (6.9%, 69.2±13.5 359 (2.7%, 69.8±12.7 cases mild, moderate, severe PHT, respectively. The all stages was 15.2 million men/annum 12.5 women/annum. Overall, increased by +7.4 (IQR +4.6 +10.1) +30.7 +26.0 +37.3) mmHg; E:e' ratio +1.0 −0.4 +3.2) +3.6 +2.0 +8.2); LA volume +5.0 +0.0 +12.0) +19.5 +9.0 +31.0) ml/m2, respectively, mild groups between first last echocardiograms. During subsequent 8.1 follow-up, 2,776/13,448 (20.6%) died all-cause. Compared age- sex-adjusted hazard ratios 1.35 (95% confidence interval, CI 1.23–1.47) 1.94 1.73–2.18) moderate 2.43 2.09–2.83) (all p<0.001). Conclusions New onset is common finding among followed-up echocardiography. Even milder stage associated higher mortality, reinforcing need proactive evaluation symptoms consistent PHT. Funding Acknowledgement Type funding sources: Private grant(s) and/or Sponsorship. Main source(s): Johnson & Johnson: Investigator-initiated grant