Prevalence of pulmonary hypertension in end-stage cystic fibrosis and correlation with survival.
BACKGROUND
Limited information is available about the prevalence of pulmonary hypertension diagnosed by right heart catheterization (RHC) in patients with cystic fibrosis being evaluated for lung transplantation. It is unclear whether there are factors that can predict the presence of pulmonary hypertension and whether the presence of pulmonary hypertension influences patient outcomes.


METHODS
The study included 57 unique and consecutive adult patients (33 women) with cystic fibrosis who underwent lung transplant evaluation at the University of Florida.


RESULTS
The average age at evaluation was 31.8 +/- 10 years. All patients were in New York Heart Association class III. The median (interquartile range) of mean pulmonary artery pressure (PAP) was 26 (24-30) mm Hg. Thirty-six patients (63.2%) had pulmonary hypertension (mean PAP >or= 25 mm Hg) and had a significantly higher degree of hypoxemia and oxygen requirements. Echocardiography evidenced limitations for the diagnosis of pulmonary hypertension. The 5-year mortality rate was similar in patients with or without pulmonary hypertension; however, it was higher in 7 patients identified by cluster analysis and in patients with a left ventricular ejection fraction < 55%.


CONCLUSIONS
More than half of our patients with cystic fibrosis and advanced lung disease have elevation of PAP, usually of mild degree. A lower left ventricular ejection fraction, but not the presence of pulmonary hypertension, was associated with worse outcomes.
Tonelli
Adriano R
AR
Pulmonary Vascular Disease, Department of Internal Medicine, University of Florida, Gainesville, Florida, USA. Adriano.Tonelli@medicine.ufl.edu
Fernandez-Bussy
Sebastian
S
Lodhi
Saba
S
Akindipe
Olufemi A
OA
Carrie
Robin D
RD
Hamilton
Karen
K
Mubarak
Kamal
K
Baz
Maher A
MA
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D003550:Cystic Fibrosis / Q000150:complications* / Q000601:surgery*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology* / Q000401:mortality* / Q000503:physiopathology; D016040:Lung Transplantation; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate