Hot topics from the Assemblies
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چکیده
Breathe | June 2017 | Volume 13 | No 2 141 Association of borderline pulmonary hypertension with mortality and hospitalization in a large patient cohort: insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking program Authors: Maron BA, Hess E, Maddox TM, et al. Circulation 2016; 133: 1240–1248. Summary: Pulmonary hypertension (PH) diagnostic criteria are currently defined as a mean pulmonary arterial pressure (mPAP) ≥25 mmHg measured during a resting right heart catheterisation (RHC). However, the upper limit of normal for mPAP is believed to be around 20 mmHg. Patients with mPAP >20 mmHg but <25 mmHg are considered as having “borderline” PH. The clinical and prognostic relevance of this population is not completely understood. In this study, using the Veterans Affairs Clinical Assessment, Reporting, and Tracking programme, Maron et al. aimed to assess the clinical relevance of borderline PH among 21 727 patients undergoing RHC. The authors demonstrated that mortality risk increases with increasing resting mPAP, beginning at 19 mmHg, and that mPAP 19–24 mmHg is associated with a higher chance of hospitalisation and/or mortality compared to patients with mPAP <19 mmHg. The deleterious impact of borderline PH on patient’s outcomes was maintained even after the exclusion of subjects with elevated resting pulmonary arterial wedge pressure and pulmonary vascular resistance. This study is the largest to date to evaluate the association between increasing levels of resting mPAP currently considered to be normal, and rates of hospitalisation and mortality. The findings provide important additional framework for the understanding of the continuum of PH and suggest that borderline PH is clinically relevant to patients’ outcomes. Further studies in independent populations are now needed. Reviewed by: Rudolf K.F. Oliveira (Brazil, Assembly 4)
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عنوان ژورنال:
دوره 13 شماره
صفحات -
تاریخ انتشار 2017