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Atrial volumes ratio as a predictor of hemodynamic phenotype in patients with pulmonary hypertension

Session Poster Session 3

Speaker Rafael Santos

Congress : Heart Failure 2019

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Pulmonary Hypertension
  • Session type : Poster Session
  • FP Number : P1819

Authors : N P D Cunha (Lisbon,PT), R Placido (Lisbon,PT), T Guimaraes (Lisbon,PT), N Cortez-Dias (Lisbon,PT), JR Agostinho (Lisbon,PT), I Aguiar-Ricardo (Lisbon,PT), J Rigueira (Lisbon,PT), R Santos (Lisbon,PT), A Nunes-Ferreira (Lisbon,PT), T Rodrigues (Lisbon,PT), A Mineiro (Lisbon,PT), S Martins (Lisbon,PT), N Lousada (Lisbon,PT), FJ Pinto (Lisbon,PT)

N P D Cunha1 , R Placido1 , T Guimaraes1 , N Cortez-Dias1 , JR Agostinho1 , I Aguiar-Ricardo1 , J Rigueira1 , R Santos1 , A Nunes-Ferreira1 , T Rodrigues1 , A Mineiro2 , S Martins1 , N Lousada1 , FJ Pinto1 , 1Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department - Lisbon - Portugal , 2Pulido Valente Hospital/CHULN, Pneumology Department - Lisbon - Portugal ,


Introduction: Characterization of the hemodynamic profile in pulmonary hypertension (PH) is crucial for the diagnosis and for deciding the appropriate therapeutic strategy. However, given its invasive nature, it is necessary to develop alternative, non-invasive predictors of the hemodynamic classification. Considering the different patterns of atrial overload due to different PH profiles, we intend to determine the role of the relation between the atrial volumes ratio and the hemodynamic classification.

Results: 174 patients were included, 69.9% females, with a mean age of 68 years old (IQR:24). 60% (N=105) had pre-capilary PH, 14% (N=25) isolated pos-capilary PH and 25% (N=44) combined pos-capilary PH. The ratio RA/LA was higher in patients with pre-capillary PH when compared to patients with combined PH and isolated pos-capillary PH (1.42±0.83 vs 1.18±0.92 vs 0.95±0.42, respectively; p=0,019). A ratio RA/LA of 1.31 allowed to differentiate with reasonable diagnostic accuracy (AUC:0.63, specificity:74%, sensibility:50%, NPV:92%, PPV:64%) the pre-capillary phenotype from others.

Conclusion: The ratio RA/LA assessed by TTE is a useful parameter to distinguish between pre-capillary and post-capillary PH.

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