Prognostic importance of pulmonary hypertension in patients with heart failure.
Pulmonary hypertension is a well-known complication in heart failure, but its prognostic importance is less well established. This study assessed the risk associated with pulmonary hypertension in patients with heart failure with preserved or reduced left ventricular (LV) ejection fractions. Patients with known or presumed heart failure (n = 388) underwent the echocardiographic assessment of pulmonary systolic pressure and LV ejection fraction. Patients were followed for up to 5.5 years. Increased pulmonary pressure was associated with increased short- and long-term mortality (p <0.0001 and p = 0.003, respectively). This relation was also present when stratifying patients by reduced or preserved LV function. A Cox proportional-hazards model apportioned a 9% increase in mortality per 5 mm Hg increase in right ventricular systolic pressure (p = 0.0008), independent of age and known chronic obstructive lung disease, heart failure, and impaired renal function. In conclusion, pulmonary hypertension is associated with increased short- and long-term mortality in patients with reduced LV ejection fractions and also in patients with preserved LV ejection fractions.
Kjaergaard
Jesper
J
The Heart Centre, Rigshospitalet, Copenhagen, Demark. jesper.kjaergaard@rh.dk
Akkan
Dilek
D
Iversen
Kasper Karmark
KK
Kjoller
Erik
E
Køber
Lars
L
Torp-Pedersen
Christian
C
Hassager
Christian
C
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002303:Cardiac Output, Low / Q000503:physiopathology*; D048909:Diabetes Complications / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D007674:Kidney Diseases / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D018570:Risk Assessment; D012907:Smoking / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D017725:Ventricular Pressure / Q000502:physiology