title: Pulmonary artery systolic pressure and mortality in the oldest old.
abstract: OBJECTIVE
  The objectives of the study were to assess pulmonary artery systolic pressure, its association with clinical and echocardiographic variables and its impact on 5-year mortality in a community-dwelling population of the oldest old.
  
  
  METHODS
  Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed at home, with standard measurements being taken including tricuspid regurgitation (TR) velocity (n = 300). Survival status at 5-year follow-up was assessed via the centralized population registry.
  
  
  RESULTS
  The mean TR gradient in the study population as a whole was 30.5 ± 9.4 mm Hg. A significant relationship was noted between right-ventricular systolic pressure (RVSP) and left-atrial (LA) volume (r = 0.27, p < 0.0001), left-ventricular (LV) mass index (r = 0.26, p < 0.0001) and the ratio E/e (r = 0.19, p < 0.03). At the 5-year follow-up, 71 of the 300 subjects (23.7%) had died. TR gradient was significantly associated with mortality in both the unadjusted (HR 1.036, 95% CI 1.015-1.058; p < 0.007) and adjusted (HR 1.036, 95% CI 1.012-1.061; p < 0.0029) models.
  
  
  CONCLUSIONS
  We demonstrate that RVSP is elevated and related to LV mass, LA volume and reduced diastolic function in the oldest old. An elevated RVSP is significantly associated with mortality in this population.
authors.affiliation: Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center and Hebrew University Hadassah Medical School, Jerusalem, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Leibowitz
authors.forename: Dan
authors.initials: D
authors.lastname: Gilon
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Jacobs
authors.forename: Irit
authors.initials: I
authors.lastname: Stessman-Lande
authors.forename: Jochanan
authors.initials: J
authors.lastname: Stessman
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology; D006699:Home Care Services; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D019095:Point-of-Care Systems; D011651:Pulmonary Artery / Q000502:physiology*; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000503:physiopathology*