title: Prognostic Factors for Survival in Pulmonary Hypertension Due to Left Heart Disease.
abstract: BACKGROUND
  The epidemiological data of pulmonary hypertension (PH) due to left heart disease (LHD) are limited. This study investigated hemodynamic and clinical factors associated with mortality in patients with PH due to LHD.
  
  
  RESULTS
  We conducted a retrospective review in 243 patients with PH due to LHD, defined as mean pulmonary arterial pressure ≥25 mmHg and pulmonary wedge pressure >15 mmHg at rest in right heart catheterization. Kaplan-Meier and Cox proportional hazard regression analyses were performed. Seventy-five patients died during an average follow-up of 52 months (range, 20-73 months). On multivariate analysis, only diastolic pulmonary vascular pressure gradient (DPG) ≥7 mmHg among hemodynamic measurements was a predictor of mortality. Elevated N-terminal pro-brain natriuretic peptide (NT-pro BNP), more severe New York Heart Association (NYHA) class, anemia, and renal dysfunction were more strongly associated with mortality. Mean right atrial pressure (RAP) and currently available markers of pulmonary vascular remodeling including transpulmonary pressure gradient (TPG) and pulmonary vascular resistance (PVR) had no effect on survival.
  
  
  CONCLUSIONS
  DPG is weakly associated with mortality in PH due to LHD. Clinical factors such as NT-pro BNP, NYHA class, anemia and renal dysfunction are superior predictors. The prognostic ability of hemodynamic factors such as mean RAP, TPG, PVR and DPG is limited.
authors.affiliation: Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Yamabe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dohi
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujisaki
authors.forename: Akifumi
authors.initials: A
authors.lastname: Higashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hidaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012189:Retrospective Studies; D015996:Survival Rate; D066253:Vascular Remodeling
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain