Incident pulmonary hypertension in 13 488 cases investigated with repeat echocardiography: a clinical cohort study.
ERJ Open Res
; 9(5)2023 Sep.
Article
in En
| MEDLINE
| ID: mdl-37701368
ABSTRACT
Background:
We addressed the paucity of data describing the characteristics and natural history of incident pulmonary hypertension.Methods:
Adults (n=13 448) undergoing routine echocardiography without initial evidence of pulmonary hypertension (estimated right ventricular systolic pressure, eRVSP <30.0â mmHg) or left heart disease were studied. Incident pulmonary hypertension (eRVSP ≥30.0â mmHg) was detected on repeat echocardiogram a median of 4.1â years apart. Mortality was examined according to increasing eRVSP levels (30.0-39.9, 40.0-49.9 and ≥50.0â mmHg) indicative of mild-to-severe pulmonary hypertension.Results:
A total of 6169 men (45.9%, aged 61.4±16.7â years) and 7279 women (60.8±16.9â years) without evidence of pulmonary hypertension were identified (first echocardiogram). Subsequently, 5412 (40.2%) developed evidence of pulmonary hypertension, comprising 4125 (30.7%), 928 (6.9%) and 359 (2.7%) cases with an eRVSP of 30.0-39.9â mmHg, 40.0-49.9â mmHg and ≥50.0â mmHg, respectively (incidence 94.0 and 90.9 cases per 1000 men and women, respectively, per year). Median (interquartile range) eRVSP increased by +0.0 (-2.27 to +2.67) mmHg and +30.68 (+26.03 to +37.31) mmHg among those with eRVSP <30.0â mmHg versus ≥50.0â mmHg. During a median 8.1â years of follow-up, 2776 (20.6%) died from all causes. Compared to those with eRVSP <30.0â mmHg, the adjusted risk of all-cause mortality was 1.30-fold higher in 30.0-39.9â mmHg, 1.82-fold higher in 40.0-49.9â mmHg and 2.11-fold higher in ≥50.0â mmHg groups (all p<0.001).Conclusions:
New-onset pulmonary hypertension, as indicated by elevated eRVSP, is a common finding among older patients without left heart disease followed-up with echocardiography. This phenomenon is associated with an increased morality risk even among those with mildly elevated eRVSP.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
ERJ Open Res
Year:
2023
Document type:
Article
Affiliation country:
Australia