title: Pulmonary Arterial Capacitance Predicts Cardiac Events in Pulmonary Hypertension Due to Left Heart Disease.
abstract: BACKGROUND
  Although pulmonary hypertension due to left heart disease (LHD-PH) accounts for the largest proportion of pulmonary hypertension, few reports on the epidemiological analysis of LHD-PH exist. Recently, pulmonary arterial capacitance (PAC) has attracted attention as a possible factor of right ventricular afterload along with pulmonary vascular resistance. We therefore investigated the clinical significance of PAC in LHD-PH.
  
  
  METHODS
  The subject consisted of 252 LHD-PH patients (145 men, mean age 63.4 ± 14.7 years) diagnosed by right heart catheterization. PAC was estimated by the ratio between stroke volume and pulmonary arterial pulse pressure. Patients were classified into four groups according to the PAC (1st quartile was 0.74 to 1.76 ml/mmHg, the 2nd quartile 1.77 to 2.53 ml/mmHg, the 3rd quartile 2.54 to 3.59 ml/mmHg, and the 4th quartile 3.61 to 12.14 ml/mmHg). The end-points were defined as rehospitalization due to worsening heart failure and/or cardiac death. The Cox proportional hazard regression model was used to determine what variables were associated with cardiac events.
  
  
  RESULTS
  The patients in the 1st quartile had the lowest cardiac index and stroke volume index, and the highest mean pulmonary arterial pressure, mean pulmonary capillary wedge pressure, and pulmonary vascular resistance compared with the 2nd, 3rd, and 4th quartiles. Fifty-four patients experienced cardiac events during the follow-up period (median 943 days). The event-free rate of the 1st quartile was significantly lower than that of the 3rd and 4th quartiles (66.7% vs 82.5% [3rd quartile], P = 0.008; and 92.1% [4th quartile], P < 0.001). The Cox hazard analysis revealed that PAC was significantly associated with cardiac events (HR 0.556, 95% CI 0.424-0.730, P < 0.001).
  
  
  CONCLUSIONS
  PAC is useful in the prediction of cardiac event risk in LHD-PH patients.
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.|Department of Pulmonary Hypertension, Fukushima Medical University, Fukushima, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Akiomi
authors.initials: A
authors.lastname: Yoshihisa
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yokokawa
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Misaka
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaki
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Shu-Ichi
authors.initials: SI
authors.lastname: Saitoh
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.|Department of Pulmonary Hypertension, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology / Q000503:physiopathology*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology*; D013318:Stroke Volume; D018924:Vascular Capacitance