Document Detail


Pulmonary arterial pulse pressure and mortality in pulmonary arterial hypertension.
MedLine Citation:
PMID:  17719764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the Framingham studies, systemic arterial pulse pressure correlated linearly with morbidity and mortality. Right ventricular (RV) systolic dysfunction and pulmonary circulation stiffening result in abnormalities of pulmonary arterial (PA) pulse pressure in PA hypertension (PAH). We investigated the prognostic potential of PA pulse pressure in 67 patients with PAH diagnosed between January 1996 and March 2004 (33 idiopathic PAH, 34 PAH-connective tissue disease). The population was arbitrarily divided into tertiles of PA pulse pressure (= systolic-diastolic PA pressure) and 5-year mortality was assessed using the Kaplan-Meier method. The extent of RV systolic dysfunction and pulmonary circulation stiffening within each tertile was assessed by comparing the mean cardiac index and alpha (a recently described measure of pulmonary circulation distensibility) in each. Independent predictors of mortality were identified by Cox regression. Five-year mortality rates in patients with low, intermediate and high pulse pressures were 40%, 91% and 54%, respectively. Pulse pressure did not independently predict mortality, but cardiac index, 6-min walk test distance and mixed venous oxygen saturation did. Pulse pressure correlated with circulation stiffening (alpha) but did not correlate with cardiac index which tended to be lower in patients with intermediate pulse pressure and high mortality. PA pulse pressure correlated with pulmonary circulation stiffening but did not predict mortality in this study. RV dysfunction provided better prognostic information and probably explains the higher mortality seen in patients with intermediate pulse pressure.
Authors:
Kevin G Blyth; Raheel Syyed; James Chalmers; John E Foster; Tarek Saba; Robert Naeije; Christian Melot; Andrew J Peacock
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Publication Detail:
Type:  Journal Article     Date:  2007-08-24
Journal Detail:
Title:  Respiratory medicine     Volume:  101     ISSN:  0954-6111     ISO Abbreviation:  Respir Med     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-10-30     Completed Date:  2008-02-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  2495-501     Citation Subset:  IM    
Affiliation:
Scottish Pulmonary Vascular Unit, Western Infirmary, Dumbarton Road, G11 6NT Glasgow, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure
Diastole
Female
Humans
Hypertension, Pulmonary / mortality,  physiopathology*
Male
Middle Aged
Prognosis
Proportional Hazards Models
Pulmonary Artery / physiopathology*
Regression Analysis
Retrospective Studies
Survival Rate
Systole
Vascular Resistance
Ventricular Dysfunction, Right / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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