title: Pulmonary hypertension after pneumonectomy for lung cancer.
abstract: BACKGROUND
  We aimed to consolidate our clinical observations regarding the development of pulmonary hypertension following pneumonectomy for lung cancer.
  
  
  METHODS
  Sixty-nine of 82 initially selected patients without pulmonary or cardiac comorbidities, who underwent pneumonectomy for lung cancer between October 2009 and October 2011, accomplished our protocol. Mean patient age was 60.6 years (range 44-78 years) and 10.1% were women.
  
  
  RESULTS
  Postoperative complications occurred in 16 (23.2%) patients. Mortality at 1, 12, and 18 months postoperatively was 4.3%, 15.9%, and 29%, respectively. One year postoperatively, 37.9% of patients developed mild to moderate pulmonary hypertension and 3.4% had severe pulmonary hypertension. The calculated mean pulmonary artery systolic pressure at 1, 6, and 12 months postoperatively was 21.9 ± 6.6, 27.3 ± 9.3, and 34.1 ± 14 mm Hg, respectively (p < 0.001). Receiver operating characteristic curve analysis showed a cutoff point at 35.5 mm Hg for late postoperative (at 12 months) pulmonary artery systolic pressure (sensitivity 80%, specificity 82%; p < 0.001) related to suboptimal clinical outcomes (decreased performance status or death), with a detected 18-fold risk for these patients (p < 0.001).
  
  
  CONCLUSIONS
  Pulmonary hypertension may occur after pneumonectomy with its known adverse effects. Patients with late postoperative pulmonary artery systolic pressure > 35.5 mm Hg are at higher risk of a suboptimal clinical outcome.
authors.affiliation: Department of Thoracic Surgery, Sotiria General Hospital for Chest Diseases, Athens, Greece konstantinospotaris@yahoo.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Potaris
authors.affiliation: Department of Thoracic Surgery, Sotiria General Hospital for Chest Diseases, Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Athanasiou
authors.affiliation: Department of Thoracic Surgery, Sotiria General Hospital for Chest Diseases, Athens, Greece.
authors.forename: Marios
authors.initials: M
authors.lastname: Konstantinou
authors.affiliation: Department of Cardiology, Sotiria General Hospital for Chest Diseases, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Zaglavira
authors.affiliation: Department of Cardiology, Sotiria General Hospital for Chest Diseases, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Theodoridis
authors.affiliation: Oncology Unit of the 3rd Internal Medicine Clinic of Athens University, Sotiria General Hospital for Chest Diseases, Athens, Greece.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Syrigos
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology*; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: Hypertension; echocardiography; lung neoplasms; pneumonectomy; pulmonary; pulmonary artery