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Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes

BACKGROUND: Although detection of elevated right ventricular systolic pressure (RVSP) on routine echocardiography is common, its clinical significance is underappreciated. The recent change in the hemodynamic definition of pulmonary hypertension (PH) lowering the threshold from mean pulmonary arteri...

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Autores principales: Xiong, Ping Yu, Jaff, Zardasht, D’Arsigny, Christine L., Archer, Stephen L., Wijeratne, Don Thiwanka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499396/
https://www.ncbi.nlm.nih.gov/pubmed/32995717
http://dx.doi.org/10.1016/j.cjco.2020.04.001
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author Xiong, Ping Yu
Jaff, Zardasht
D’Arsigny, Christine L.
Archer, Stephen L.
Wijeratne, Don Thiwanka
author_facet Xiong, Ping Yu
Jaff, Zardasht
D’Arsigny, Christine L.
Archer, Stephen L.
Wijeratne, Don Thiwanka
author_sort Xiong, Ping Yu
collection PubMed
description BACKGROUND: Although detection of elevated right ventricular systolic pressure (RVSP) on routine echocardiography is common, its clinical significance is underappreciated. The recent change in the hemodynamic definition of pulmonary hypertension (PH) lowering the threshold from mean pulmonary arterial pressure ≥ 25 mm Hg to > 20 mm Hg further clouds the picture. METHODS: A retrospective cohort study was performed on residents of the South East Local Health Integration Network (population 495,000), Ontario, Canada, who underwent transthoracic echocardiography at the Kingston Health Sciences Centre between February 19, 2013, and December 31, 2016. The index echocardiography from 9291 unique patients was obtained. RESULTS: A total of 2049 patients (22.1%) had an RVSP ≥ 40 mm Hg, 2040 patients (22.0%) had an RVSP ≥ 30 and < 40 mm Hg, but only 284 patients (3.1%) had a clinical diagnosis of PH. Although patients with an RVSP ≥ 40 mm Hg had the highest Charlson Comorbidity Index (CCI) (1.81 ± 0.05) and number of hospitalizations 1 year before the echocardiography (1.24 ± 0.03), patients with RVSP between 30 and 40 mm Hg also had significantly higher CCI (1.19 ± 0.04) and hospitalization (0.87 ± 0.03) compared with the CCI (0.84 ± 0.03) and hospitalization (0.65 ± 0.02) of patients with RVSP < 30 mm Hg (P < 0.0001). CONCLUSION: Despite the finding that an elevated RVSP ≥ 30 mm Hg is common and predicts adverse outcomes, most patients with elevated RVSP are not reported as having PH or investigated. The significance of the elevated RVSP is underappreciated.
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spelling pubmed-74993962020-09-28 Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes Xiong, Ping Yu Jaff, Zardasht D’Arsigny, Christine L. Archer, Stephen L. Wijeratne, Don Thiwanka CJC Open Original Article BACKGROUND: Although detection of elevated right ventricular systolic pressure (RVSP) on routine echocardiography is common, its clinical significance is underappreciated. The recent change in the hemodynamic definition of pulmonary hypertension (PH) lowering the threshold from mean pulmonary arterial pressure ≥ 25 mm Hg to > 20 mm Hg further clouds the picture. METHODS: A retrospective cohort study was performed on residents of the South East Local Health Integration Network (population 495,000), Ontario, Canada, who underwent transthoracic echocardiography at the Kingston Health Sciences Centre between February 19, 2013, and December 31, 2016. The index echocardiography from 9291 unique patients was obtained. RESULTS: A total of 2049 patients (22.1%) had an RVSP ≥ 40 mm Hg, 2040 patients (22.0%) had an RVSP ≥ 30 and < 40 mm Hg, but only 284 patients (3.1%) had a clinical diagnosis of PH. Although patients with an RVSP ≥ 40 mm Hg had the highest Charlson Comorbidity Index (CCI) (1.81 ± 0.05) and number of hospitalizations 1 year before the echocardiography (1.24 ± 0.03), patients with RVSP between 30 and 40 mm Hg also had significantly higher CCI (1.19 ± 0.04) and hospitalization (0.87 ± 0.03) compared with the CCI (0.84 ± 0.03) and hospitalization (0.65 ± 0.02) of patients with RVSP < 30 mm Hg (P < 0.0001). CONCLUSION: Despite the finding that an elevated RVSP ≥ 30 mm Hg is common and predicts adverse outcomes, most patients with elevated RVSP are not reported as having PH or investigated. The significance of the elevated RVSP is underappreciated. Elsevier 2020-04-09 /pmc/articles/PMC7499396/ /pubmed/32995717 http://dx.doi.org/10.1016/j.cjco.2020.04.001 Text en © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Xiong, Ping Yu
Jaff, Zardasht
D’Arsigny, Christine L.
Archer, Stephen L.
Wijeratne, Don Thiwanka
Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes
title Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes
title_full Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes
title_fullStr Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes
title_full_unstemmed Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes
title_short Evaluation of the Impact of an Echocardiographic Diagnosis of Pulmonary Hypertension on Patient Outcomes
title_sort evaluation of the impact of an echocardiographic diagnosis of pulmonary hypertension on patient outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7499396/
https://www.ncbi.nlm.nih.gov/pubmed/32995717
http://dx.doi.org/10.1016/j.cjco.2020.04.001
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