Risk factors for perioperative morbidity and mortality in pulmonary hypertension patients

Patient characteristics
PAH >mixed or postcapillary PH [33, 58]
History of PE, coronary artery disease, OSA or chronic renal insufficiency [28, 30, 59]
WHO functional class III and IV [41]
ASA class>II [30]
6MWD <400 m [30]
ECG: right-axis deviation [30]
NT-proBNP≥300 pg·mL−1 [41]
TTE: RV hypertrophy, RV index of myocardial performance ≥0.75, RVSP/SBP ≥0.66 [34, 59, 60]
Pulmonary haemodynamics: mPAP >45 mmHg, elevated RAP [61] or sPAP >70 mmHg,
CI <2 L·min−1·m−2 [30]
Anaesthesia attributes
Duration of anaesthesia >3 h [29, 58]
Perioperative use of vasopressors [34, 60]
Intermediate to high-risk surgery [41]
Emergency procedures [32, 60].

6MWD: six-minute walk distance; ASA: American Society of Anesthesiology; CI: cardiac index; ECG: electrocardiogram; mPAP: mean pulmonary artery pressure, NT-proBNP: N-terminal pro-brain natriuretic peptide; OSA: obstructive sleep apnoea; PAH: pulmonary arterial hypertension; PE: pulmonary embolism; PH: pulmonary hypertension; PVR: pulmonary vascular resistance; RAP: right atrial pressure; RV: right ventricle; RVSP: right ventricle systolic pressure; sPAP: systolic pulmonary artery pressure; SBP: systolic blood pressure; TTE: transthoracic echocardiography; WHO: World Health Organization.