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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9735657 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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