title: Prognostic Relevance of Nonsustained Ventricular Tachycardia in Patients with Pulmonary Hypertension.
abstract: Background.Increased pulmonary vascular resistance in patients with pulmonary hypertension (PH) leads to an increased afterload of right heart and cardiac remodeling which could provide the substrate or trigger for arrhythmias. Supraventricular arrhythmias were associated with clinical deterioration but were not associated with sudden cardiac death (SCD). SCD has been reported to account for approximately 30% of deaths in patients with pulmonary arterial hypertension (PAH).Objective.The role of nonsustained ventricular tachycardia (nsVT) and its prognostic relevance in patients with PH remains unclear. This study evaluated the prognostic relevance of nsVT in patients with PAH and chronic thromboembolic pulmonary hypertension (CTEPH).Methods.Retrospectively, patients with PAH and CTEPH who underwent Holter ECG monitoring and available data of survival were investigated.Results.Seventy-eight (PAH: 55, CTEPH: 23) patients were evaluated. Holter ECG revealed nsVT in 12 patients. Twenty-one patients died during follow-up. In patients with nsVT, tricuspid annular plane systolic excursion was lower (p= 0.001), and systolic pulmonary arterial pressure was higher (p= 0.163). Mean survival of patients without/with nsVT was 155.2 ± 8.5/146.4 ± 21.4 months (p= 0.690). The association between arrhythmias and survival was not confounded by age (p= 0.681), gender (p= 0.752), 6-MW distance (p= 0.196), or arterial hypertension (p= 0.238).Conclusions.In patients with PH, nsVT occurs more often than previously reported, and patients with PH group 1 seem to be more at risk.
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), The German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany.
authors.forename: Dirk
authors.identifier: 0000-0001-5341-5195
authors.initials: D
authors.lastname: Bandorski
authors.affiliation: Klinikum Lüdenscheid, Universität Witten-Herdecke, Medizinische Klinik III, Paulmannhöherstr. 14, 58515 Lüdenscheid, Germany.
authors.forename: Harilaos
authors.initials: H
authors.lastname: Bogossian
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), The German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Stempfl
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), The German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Seeger
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), The German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hecker
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), The German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany.
authors.forename: Ardeschir
authors.initials: A
authors.lastname: Ghofrani
authors.affiliation: Klinikum Westmünsterland, St. Agnes-Hospital Bocholt-Rhede, Medical Clinic 1-Cardiology/Electrophysiology, Barloer Weg 125, 46397 Bocholt, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hoeltgen
authors.affiliation: University of Giessen and Marburg Lung Center (UGMLC), The German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Gall
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000401:mortality / Q000503:physiopathology