Prognostic Value of Systolic Pulmonary Artery Pressure Determined by Echocardiography in Patients with Pulmonary Hypertension

摘要

Pulmonary hypertension is a hemodynamic and pathophysiological condition defined as an increase in mean pulmonary pressure more than or equal to 25 mm Hg. Risk stratification and prognostic evaluation in patients wilh pulmonary hypertension are complex and require multiple investigations. There is a lack of consensus on factors that predict mortality and prognosis in patients with pulmonary arterial hypertension. The aim of our study was to identify the prognostic value of the systolic pulmonary artery pressure, determined by echocardiography, in patients with pulmonary hypertension. We performed a prospective study that included 553 patients diagnosed with pulmonary hypertension in the Institute of Cardiovascular Diseases of Iasi between 2008 and 2011. We found that severe pulmonary hypertension (defined as systolic pulmonary artery pressure above 70 mm Hg) is closely related to increased mortality, survival duration, number of hospitalizations for clinical worsening and heart failure phenomena and longer hospitalization duration. We also found a statistically higher risk of patients with systolic pulmonary artery pressure > 70 mm Hg for mechanical ventilation and renal, hepatic and pericardial complications. We found no association between the systolic pulmonary artery pressure value and need for inotropic support or pleural complications. Conclusions: Echocardiography provides very useful prognostic tools in patients with pulmonary hypertension. Echocardiography is very accurate in assessing systolic pulmonary artery pressure. Systolic pulmonary artery pressure can be used as an indicator of severity and prognosis in these patients.