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Hemodynamic profile of pulmonary arterial hypertension: comparison among subgroups. Insights of the first collaborative registry of pulmonary hypertension in Argentina (RECOPILAR)

Session Poster Session 3

Speaker Maria Lorena Coronel

Congress : Heart Failure 2019

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Pulmonary Hypertension
  • Session type : Poster Session
  • FP Number : P1821

Authors : ML Coronel (Corrientes,AR), ER Perna (Corrientes,AR), D Echazarreta (La Plata,AR), G Tuhay (Buenos Aires,AR), ML Talavera (Buenos Aires,AR), L Lema (Cordoba,AR), Y Bazan (Rosario,AR), V Gregorietti (Florencio Varela,AR), B Varela (Buenos Aires,AR), A Guerrero (San Luis,AR), D Bustos (Venado Tuerto,AR), M Quaranta (Resistencia,AR), V Quino (Cordoba,AR), M Cordoba (Mar del Plata,AR)

Authors:
ML Coronel1 , ER Perna1 , D Echazarreta2 , G Tuhay3 , ML Talavera4 , L Lema5 , Y Bazan6 , V Gregorietti7 , B Varela8 , A Guerrero9 , D Bustos10 , M Quaranta11 , V Quino5 , M Cordoba12 , 1J.F. Cabral Cardiology Institute - Corrientes - Argentina , 2Hospital San Juan de Dios - La Plata - Argentina , 3Favaloro Foundation University Hospital - Buenos Aires - Argentina , 4Cardiovascular Institute of Buenos Aires (ICBA) - Buenos Aires - Argentina , 5Model Institute of Cardiology - Cordoba - Argentina , 6Instituto de Cardiologia Gonzalez Sabathie - Rosario - Argentina , 7Hospital El Cruce - Florencio Varela, Buenos Aires - Argentina , 8Hospital Aleman - Buenos Aires - Argentina , 9Asociacion Argentina de Medicina Respiratoria - San Luis - Argentina , 10Asociacion Argentina de Medicina Respiratoria - Venado Tuerto - Argentina , 11Hospital Perrando - Resistencia - Argentina , 12Hospital Interzonal General de Agudos - Mar del Plata - Argentina ,

On behalf: RECOPILAR

Citation:

Hemodynamic of pulmonary arterial hypertension (PAH) has been poorly characterized in Latin America.

The aim of this report was to compare the hemodynamic and clinical profile among subgroups of PAH in Argentina.

Method: From Jul-14 to Oct-16, 399 incident and prevalent patients with PAH were prospectively included by 72 investigators from 23 provinces of Argentina in a collaborative registry. Patients must fulfill all the following inclusion criteria: 1-Age over three months; 2 - mean pulmonary arterial pressure (mPAP) at rest = 25 mmHg by right heart catheterization (RHC) and 3 - clinical stability in the absence of hospitalization in last month. The subgroups of PAH were defined as idiopathic, heritable or drugs associated (1), associated with connective tissue disease (2), HIV (3), porto-pulmonary hypertension (4), and congenital heart disease (5).

Results: The proportion of patients in subgroups 1 to 5 was: 1=41.9%, 2=23.8%, 3=5%, 4=4% and 5: 25.3%. The full comparison of clinical characteristics and hemodynamics parameter is shown in Table. Conclusion: In concordance with other international surveys, this Latin American registry showed that despite differences in hemodynamic profile among subgroups in PAH the clinical presentation was similar.

These findings suggest that different factors besides hemodynamic may have influence in the severity of the disease.

Subgroups

1

2

3

4

5

p

Age, years (SD)

44.9

(18.6)

56.3

(15.1)

46

(8.6)

55.9

(10.1)

41.4

(19.3)

<0.001

Female, %

82.6

89.5

45

56.3

72.3

<0.01

Sistolic Blood Pressure, mmHg (SD)

117 (24)

125 (23.9)

120 (21)

117 (21)

115 (21)

0.090

Cardiac Index, l/min/m2 (SD)

2.7

(0.9)

2.6

(0.8)

2.9

(0.9)

4.2

(1.9)

2.9

(0.9)

<0.001

Pulmonary Vascular Resistance, dynas (SD)

884

(496)

677

(394)

680

(298)

507

(287)

836

(596)

0.006

mean Pulmonary Arterial Pressure, mmHg (SD)

55.6

(16.9)

45.3

(13.2)

47.9

(13)

47.2

(14.8)

54.8

(18.2)

<0.001

Right Atrial Pressure, mmHg (SD)

10.2

(5.9)

9.2

(5.7)

8

(4.2)

7.9

(4.6)

9.4

(4.5)

0.370

Wedge Pressure, mmHg (SD)

10.9

(5.6)

10.5

(3.3)

11.2

(4.4)

14.5

(4.6)

11.1

(3.4)

0.090

SatvO2, % (SD)

70.5

(15.1)

68.5

(9.6)

64

(20.2)

68.2

(10.5)

74.3

(12)

0.180

Trans Pulmonary Gradient (SD)

43.8

(16)

35.1

(13.4)

38

(10)

34.5

(17.4)

42.5

(17.3)

0.001

Diastolic Pulmonary Gradient (SD)

26.8

(14.1)

18.7

(9.2)

27.6

(9.3)

17.2

(13.2)

24.6

(13.9)

<0.001

Functional Class III-IV (%)

63.6

70.2

85.7

41.7

61.4

0.131

6 Min Walk test, m (SD)

368

(125)

344

(116)

385

(105)

390

(85)

380

(114)

0.380

NT-proBNP, pg/ml (SD)

1187

(1708)

1095

(1397)

740

(711)

625

(860)

794

(1360)

0.690

SD standard deviation



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