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Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry

Pulmonary arterial hypertension (PAH) in the elderly is often associated with left heart disease (LHD), prompting concerns about the use of pulmonary vasodilators. The PATRIARCA registry enrolled ≥70 year-old PAH or chronic thromboembolic pulmonary hypertension (CTEPH) patients at 11 Italian centers...

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Autores principales: Toma, Matteo, Miceli, Roberta, Bonsante, Edoardo, Colombo, Davide, Confalonieri, Marco, Garascia, Andrea, Ghio, Stefano, Lattanzio, Mariangela, Lombardi, Carlo Maria, Paciocco, Giuseppe, Piccinino, Cristina, Rota, Irene, Santolamazza, Caterina, Scelsi, Laura, Scuri, Piermario, Stolfo, Davide, Vincenzi, Antonella, Volpiano, Lorenzo, Vicenzi, Marco, Ameri, Pietro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735657/
https://www.ncbi.nlm.nih.gov/pubmed/36498710
http://dx.doi.org/10.3390/jcm11237136
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author Toma, Matteo
Miceli, Roberta
Bonsante, Edoardo
Colombo, Davide
Confalonieri, Marco
Garascia, Andrea
Ghio, Stefano
Lattanzio, Mariangela
Lombardi, Carlo Maria
Paciocco, Giuseppe
Piccinino, Cristina
Rota, Irene
Santolamazza, Caterina
Scelsi, Laura
Scuri, Piermario
Stolfo, Davide
Vincenzi, Antonella
Volpiano, Lorenzo
Vicenzi, Marco
Ameri, Pietro
author_facet Toma, Matteo
Miceli, Roberta
Bonsante, Edoardo
Colombo, Davide
Confalonieri, Marco
Garascia, Andrea
Ghio, Stefano
Lattanzio, Mariangela
Lombardi, Carlo Maria
Paciocco, Giuseppe
Piccinino, Cristina
Rota, Irene
Santolamazza, Caterina
Scelsi, Laura
Scuri, Piermario
Stolfo, Davide
Vincenzi, Antonella
Volpiano, Lorenzo
Vicenzi, Marco
Ameri, Pietro
author_sort Toma, Matteo
collection PubMed
description Pulmonary arterial hypertension (PAH) in the elderly is often associated with left heart disease (LHD), prompting concerns about the use of pulmonary vasodilators. The PATRIARCA registry enrolled ≥70 year-old PAH or chronic thromboembolic pulmonary hypertension (CTEPH) patients at 11 Italian centers from 1 December 2019 through 15 September 2022. After excluding those with CTEPH, post-capillary PH at the diagnostic right heart catheterization (RHC), and/or incomplete data, 23 (33%) of a total of 69 subjects met the criteria proposed in the AMBITION trial to suspect LHD. Diabetes [9 (39%) vs. 6 (13%), p = 0.01] and chronic kidney disease [14 (61%) vs. 12 (26%), p = 0.003] were more common, and the last RHC pulmonary artery wedge pressure [14 ± 5 vs. 10 ± 3 mmHg, p < 0.001] was higher and pulmonary vascular resistance [5.56 ± 3.31 vs. 8.30 ± 4.80, p = 0.02] was lower in LHD than non-LHD patients. However, PAH therapy was similar, with 13 (57%) and 23 (50%) subjects, respectively, taking two oral drugs. PAH medication patterns remained comparable between LHD and non-LHD patients also when the former [37, 54%] were identified by atrial fibrillation and echocardiographic features of LHD, in addition to the AMBITION criteria. In this real-world snapshot, elderly PAH patients were treated with pulmonary vasodilators, including combinations, despite a remarkable prevalence of a LHD phenotype.
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spelling pubmed-97356572022-12-11 Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry Toma, Matteo Miceli, Roberta Bonsante, Edoardo Colombo, Davide Confalonieri, Marco Garascia, Andrea Ghio, Stefano Lattanzio, Mariangela Lombardi, Carlo Maria Paciocco, Giuseppe Piccinino, Cristina Rota, Irene Santolamazza, Caterina Scelsi, Laura Scuri, Piermario Stolfo, Davide Vincenzi, Antonella Volpiano, Lorenzo Vicenzi, Marco Ameri, Pietro J Clin Med Article Pulmonary arterial hypertension (PAH) in the elderly is often associated with left heart disease (LHD), prompting concerns about the use of pulmonary vasodilators. The PATRIARCA registry enrolled ≥70 year-old PAH or chronic thromboembolic pulmonary hypertension (CTEPH) patients at 11 Italian centers from 1 December 2019 through 15 September 2022. After excluding those with CTEPH, post-capillary PH at the diagnostic right heart catheterization (RHC), and/or incomplete data, 23 (33%) of a total of 69 subjects met the criteria proposed in the AMBITION trial to suspect LHD. Diabetes [9 (39%) vs. 6 (13%), p = 0.01] and chronic kidney disease [14 (61%) vs. 12 (26%), p = 0.003] were more common, and the last RHC pulmonary artery wedge pressure [14 ± 5 vs. 10 ± 3 mmHg, p < 0.001] was higher and pulmonary vascular resistance [5.56 ± 3.31 vs. 8.30 ± 4.80, p = 0.02] was lower in LHD than non-LHD patients. However, PAH therapy was similar, with 13 (57%) and 23 (50%) subjects, respectively, taking two oral drugs. PAH medication patterns remained comparable between LHD and non-LHD patients also when the former [37, 54%] were identified by atrial fibrillation and echocardiographic features of LHD, in addition to the AMBITION criteria. In this real-world snapshot, elderly PAH patients were treated with pulmonary vasodilators, including combinations, despite a remarkable prevalence of a LHD phenotype. MDPI 2022-11-30 /pmc/articles/PMC9735657/ /pubmed/36498710 http://dx.doi.org/10.3390/jcm11237136 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Toma, Matteo
Miceli, Roberta
Bonsante, Edoardo
Colombo, Davide
Confalonieri, Marco
Garascia, Andrea
Ghio, Stefano
Lattanzio, Mariangela
Lombardi, Carlo Maria
Paciocco, Giuseppe
Piccinino, Cristina
Rota, Irene
Santolamazza, Caterina
Scelsi, Laura
Scuri, Piermario
Stolfo, Davide
Vincenzi, Antonella
Volpiano, Lorenzo
Vicenzi, Marco
Ameri, Pietro
Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
title Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
title_full Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
title_fullStr Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
title_full_unstemmed Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
title_short Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry
title_sort left heart disease phenotype in elderly patients with pulmonary arterial hypertension: insights from the italian patriarca registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735657/
https://www.ncbi.nlm.nih.gov/pubmed/36498710
http://dx.doi.org/10.3390/jcm11237136
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