title: A simple hemodynamic parameter to predict clinical worsening in pulmonary arterial hypertension.
abstract: Predicting prognosis is a cornerstone in management of pulmonary arterial hypertension. Hemodynamic parameters are among the robust indicators of right ventricular function and prognosis. In this study we have investigated the association of a simple hemodynamic parameter with clinical worsening in pulmonary arterial hypertension.
  
  
  
  120 patients were enrolled in a single center prospective cohort study after confirmation of precapillary pulmonary hypertension and were followed for an average of 36months on guideline recommended treatment protocols. cSvO2was calculated as the ratio of right atrial pressure over Mixed Venous Oxygen Saturation. Independent predictors of clinical worsening were identified using multivariable Cox regression models.
  
  
  
  By the end of the follow up a total of 21 patients died and 63 were hospitalized for pulmonary hypertension. Time-to-event Cox regression model showed a strong association between cSvO2and time to clinical worsening (HR: 250.13, CI: (38.56-1622.34) &p-value: <0.0001).
  
  
  
  The index of cSvO2includes both parameters of cardiac output and right ventricular filling pressure and might be beneficial in predicting clinical worsening in patients with pulmonary arterial hypertension.
authors.affiliation: Department of Heart Failure and Transplantation, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Science, Tehran, Iran. Electronic address: amina33@gmail.com.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Amin
authors.affiliation: Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Mohamadifar
authors.affiliation: Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
authors.forename: Mohammad Sadegh
authors.initials: MS
authors.lastname: Keshmiri
authors.affiliation: Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
authors.forename: Behshid
authors.initials: B
authors.lastname: Ghadrdoost
authors.affiliation: Department of Heart Failure and Transplantation, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Taghavi
authors.affiliation: Department of Heart Failure and Transplantation, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Science, Tehran, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Naderi
mesh_terms: D000328:Adult; D062185:Atrial Pressure; D002302:Cardiac Output; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010100:Oxygen / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014655:Vascular Resistance; D014682:Vena Cava, Inferior; D014683:Vena Cava, Superior; D016278:Ventricular Function, Right; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Clinical worsening; Mixed Venous Oxygen Saturation; Prognosis; Pulmonary arterial hypertension; Right catheterization