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Clinical and prognostic relevance of echocardiographic evaluation of right ventricular geometry in patients with idiopathic pulmonary arterial hypertension
- Source :
- The American journal of cardiology. 107(4)
- Publication Year :
- 2010
-
Abstract
- The aim of the present study was to assess the clinical and prognostic significance of right ventricular (RV) dilation and RV hypertrophy at echocardiography in patients with idiopathic pulmonary arterial hypertension. Echocardiography and right heart catheterization were performed in 72 consecutive patients with idiopathic pulmonary arterial hypertension admitted to our institution. The median follow-up period was 38 months. The patients were grouped according to the median value of RV wall thickness (6.6 mm) and the median value of the RV diameter (36.5 mm). On multivariate analysis, the mean pulmonary artery pressure (p = 0.018) was the only independent predictor of RV wall thickness, and age (p = 0.011) and moderate to severe tricuspid regurgitation (p = 0.027) were the independent predictors of RV diameter. During follow-up, 22 patients died. The death rate was greater in the patients with a RV diameter >36.5 mm than in patients with a RV diameter ≤36.5 mm: 15.9 (95% confidence interval 9.4 to 26.8) vs 6.6 (95% confidence interval 3.3 to 13.2) events per 100-person years (p = 0.0442). In contrast, the death rate was similar in patients with RV wall thickness above or below the median value. However, among the patients with a RV wall thickness >6.6 mm, a RV diameter >36 mm was not associated with a poorer prognosis (p = 0.6837). In conclusion, in patients with idiopathic pulmonary arterial hypertension, a larger RV diameter is a marker of a poor prognosis but a greater RV wall thickness reduces the risk of death associated with a dilated right ventricle.
- Subjects :
- Adult
Male
medicine.medical_specialty
Cardiac Catheterization
Heart Ventricles
Hypertension, Pulmonary
Sensitivity and Specificity
Severity of Illness Index
Predictive Value of Tests
medicine.artery
Internal medicine
medicine
Confidence Intervals
Image Processing, Computer-Assisted
Humans
In patient
Familial Primary Pulmonary Hypertension
Aged
Retrospective Studies
Hypertrophy, Right Ventricular
business.industry
Mortality rate
Respiratory disease
Middle Aged
medicine.disease
Prognosis
Pulmonary hypertension
Survival Analysis
Confidence interval
medicine.anatomical_structure
Echocardiography
Pulmonary artery
Circulatory system
Multivariate Analysis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Algorithms
Artery
Follow-Up Studies
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 107
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....9d8da6886071c11e2c4bf2aa7995ea30