Prevalence and predictors of pulmonary hypertension in elderly patients with isolated diastolic heart failure.
BACKGROUND
Despite the growing recognition that pulmonary hypertension can develop in diastolic heart failure; its clinical significance remains poorly defined.


OBJECTIVE
We sought to explore the prevalence and predictors of pulmonary hypertension in elderly patients with isolated diastolic heart failure.


METHODS
We enrolled 100 consecutive elderly patients with isolated diastolic heart failure. All patients underwent transthoracic echocardiography to measure the pulmonary artery systolic pressure, diastolic function indices (mitral E peak deceleration time, isovolumetric relaxation time, early mitral annular diastolic velocity), left atrial diameter and left ventricular mass index. Pulmonary hypertension was defined as pulmonary artery systolic pressure > or = 37 mm Hg. We classified patients into two groups: one with diastolic heart failure and concomitant pulmonary hypertension, and one with diastolic heart failure but without concomitant pulmonary hypertension.


RESULTS
The mean age of the whole series was 65.4 + or - 5.4 years, 49 (49%) being female. Patients with pulmonary hypertension (20% of the whole series) were more often females, hypertensive, more likely to have atrial fibrillation, pulmonary congestion symptoms, larger left atrial diameter, lower early mitral annular diastolic velocity, lower left ventricular ejection fraction, and more likely to have mitral regurgitation (p < 0.05 for all). Multivariate logistic regression analysis identified female gender, atrial fibrillation, and early mitral annular diastolic velocity (e') as the independent predictors of the presence of pulmonary hypertension.


CONCLUSIONS
Pulmonary hypertension is fairly prevalent in elderly patients with diastolic heart failure. Female gender, atrial fibrillation, and early mitral annular diastolic velocity (e') were the independent predictors of the presence of pulmonary hypertension in this patient group.
Rifaie
Osama
O
Cardiology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
El-Damanhory
Hayam
H
Amr
May
M
Nammas
Wail
W
D017677:Age Distribution; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D054144:Heart Failure, Diastolic / Q000453:epidemiology* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008944:Mitral Valve Insufficiency / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D017678:Sex Distribution; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology