MiscellaneousPrevalence and Risk Factors of Pulmonary Hypertension in Patients With Elevated Pulmonary Venous Pressure and Preserved Ejection Fraction
Section snippets
Methods
The Dartmouth Dynamic Registry collects clinical, demographic, and procedural data on all patients who undergo cardiac catheterization at Dartmouth-Hitchcock Medical Center. The database was searched for patients who underwent right-sided and left-sided cardiac catheterization with LVEDPs >15 mm Hg, LV ejection fractions ≥50%, and no clinically significant aortic or mitral valve disease (no more than mild) from October 1996 to September 2007. The indication for heart catheterization was
Results
Among 3,097 patients who underwent right-sided and left-sided cardiac catheterization with ventriculography from October 1996 to September 2007, 455 were found to have LVEDPs >15 mm Hg, preserved LV systolic function, and no significant left-sided valvular disease. Of these, 239 (52.5%) had mean PA pressures >25 mm Hg. The demographic, clinical, and hemodynamic characteristics of our sample are listed in Table 1.
Patients with PH were more likely to be older and obese; to have diabetes, chronic
Discussion
Our study shows that the development of PH in patients with elevated LVEDPs and preserved systolic function is strongly and independently associated with LVEDP ≥25 mm Hg, body mass index >40 kg/m2, and atrial arrhythmias. Other significant independent associations were age ≥80 years, chronic obstructive pulmonary disease, and dyspnea on exertion. The prevalence of PH in our study population was 52.5%. Lam et al2 reported a PH prevalence of 83% in their echocardiography-based study of patients
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