title: A Clinical and Echocardiographic Score to Identify Pulmonary Hypertension Due to HFpEF.
abstract: BACKGROUND
  Heart failure with preserved ejection fraction (HFpEF) is a frequent cause of pulmonary hypertension (PH) that is not easy to differentiate from precapillary PH. We aimed to determine whether the characteristic features of the patients may help differentiate between HFpEF and precapillary PH.
  
  
  RESULTS
  Clinical and echocardiographic parameters were analyzed in 156 patients referred to our PH referral center. Right heart catheterization identified 78 PH-HFpEF patients and 78 with precapillary PH. Compared with precapillary PH, PH-HFpEF patients were older, with a smaller proportion of women, a higher proportion of hypertension, diabetes mellitus, atrial fibrillation and sleep apnea syndrome, and a higher body mass index. On echocardiography, PH-HFpEF patients had higher left ventricular mass index, higher left atrial area, and smaller right ventricular end-diastolic area. Following multivariate analysis, a model predicting the probability of PH-HFpEF was built with history of diabetes mellitus, presence of atrial fibrillation, left atrial area, right ventricular end-diastolic area, and left ventricular mass index. The score was internally validated using bootstrap method (area under the curve 0.93 [95% confidence interval 0.918-0.938]). A score <5 ruled out PH-HFpEF.
  
  
  CONCLUSIONS
  A score including clinical and echocardiographic criteria may help physicians to identify PH-HFpEF from precapillary PH.
authors.affiliation: AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Electronic address: emmanuelle.berthelot@aphp.fr.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Berthelot
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, LabEx LERMIT, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: David
authors.initials: D
authors.lastname: Montani
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Cardiologie, Hôpital Béclère, Clamart, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Algalarrondo
authors.affiliation: AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Dreyfuss
authors.affiliation: AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Raed
authors.initials: R
authors.lastname: Rifai
authors.affiliation: Faculté de Pharmacie, Châtenay-Malabry Cedex, and INSERM UMR_S 1180, Chatenay-Malabry, France.
authors.forename: Anouar
authors.initials: A
authors.lastname: Benmalek
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, LabEx LERMIT, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Jais
authors.affiliation: AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Amir
authors.initials: A
authors.lastname: Bouchachi
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, LabEx LERMIT, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Savale
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, LabEx LERMIT, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Simonneau
authors.affiliation: AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; AP-HP, Service de Physiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Chemla
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, LabEx LERMIT, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, Service de Pneumologie, DHU Thorax Innovation (DHU TORINO), Hôpital Bicêtre, Le Kremlin-Bicêtre, France; INSERM UMR_S 999, LabEx LERMIT, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Sitbon
authors.affiliation: AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Univ. Paris-Sud, Le Kremlin-Bicêtre, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Assayag
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*
keywords: Heart failure with preserved ejection fraction; atrial fibrillation; echocardiography; hemodynamics; pulmonary hypertension