Clinical and Echocardiographic Predictors of Outcomes in Patients With Pulmonary Hypertension

Siddiqui, Irfan; Rajagopal, Sudarshan; Brucker, Amanda; Chiswell, Karen; Christopher, Bridgette; Alenezi, Fawaz; Mandawat, Aditya; Rivera, Danny; Arges, Kristine; Tapson, Victor F.; Kisslo, Joseph; Velázquez, Eric J.; Douglas, Pamela S.; Samad, Zainab

doi:10.1016/j.amjcard.2018.05.019

Cited by 23 publications

(12 citation statements)

References 25 publications

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“…Our analysis of sonographic, sonoelastographic, and clinical cardiac variables demonstrated that only TAPSE was associated with survival in patients with PAH. This result aligns with those of other studies in the literature that have reported this parameter to be a prognostic factor in PAH [ 34 - 37 ].…”

Section: Discussionsupporting

confidence: 93%

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

et al. 2021

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Purpose The aim of this study was to evaluate the associations of sonographic and sonoelastographic parameters with clinical cardiac parameters, as well as to assess their value in predicting survival in patients with pulmonary arterial hypertension (PAH). Methods Thirty-six patients with PAH and normal liver function were prospectively enrolled in this prospective study along with 26 healthy controls, all of whom underwent ultrasound and point shear wave elastography examinations. Additionally, the portal vein pulsatility index (PVPI), inferior vena cava collapsibility index, and clinical cardiac variables were obtained in PAH patients. The values of hepatic (LV s ) and splenic shear wave velocity (SV s ) were compared between PAH patients and controls. The relationships between all sonographic and clinical parameters in the PAH patients were analyzed. Furthermore, their prognostic value in predicting survival was investigated. Results LV s values in PAH patients (median, 1.62 m/s) were significantly higher than in controls (median, 0.99 m/s), while no significant difference was observed in SV s values. Patients with higher grades of tricuspid regurgitation (TR) had significantly different values of PVPI (P=0.010) and sonoelastographic parameters (P<0.001 for LV s and P=0.004 for SV s ) compared to those with less severe TR. Tricuspid annular plane systolic excursion values were the only investigated parameter found to be associated with survival (hazard ratio, 0.814; 95% confidence interval, 0.694 to 0.954; P=0.011). Conclusion Our results demonstrated a direct association between cardiac congestion (i.e., the severity of TR) and liver stiffness, which should be kept in mind during the assessment of fibrosis in patients with PAH.

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Section: Discussionsupporting

confidence: 93%

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

et al. 2021

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“…RV strain predicted survival when adjusted for pulmonary pressure, PVR, and RAP. 97 Siddiqui et al 98 found that RV GLS was associated with hospitalization or death (n ¼ 98, HR: 1.54 per 1 SD (5.31), 95% CI: 2.12, p ¼ 0.008). In a meta-analysis of 11 studies to examine RV strain n ¼ 1169 PH patients, a 19% reduction in RVLS had a higher risk of combined endpoint HR 1.22, and a 22% reduction in RV GLS had a higher risk of all-cause mortality HR 2.96.…”

Section: Noninvasive Imaging Of the Rv Echocardiographymentioning

confidence: 99%

Role of biomarkers in evaluation, treatment and clinical studies of pulmonary arterial hypertension

et al. 2020

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“…L. Zerweck 1,2 , U. Henkemeier 2,3,4 , P. H. Nguyen 1,2 , T. Rossmanith 2,3 , A. Pippow 1,2 , H. Burkhardt 2,3,4,5 , F. Behrens 2,3,4,5 , M. Köhm 2,3,5 . 1 Background: Psoriasis (Pso) is one of the most common chronic inflammatory skin diseases in Europe.…”

Section: Assessment Of Fluorescence-optical Imaging Technique Of Thementioning

confidence: 99%

“…Zhang 1 , N. Zhang 1 , Y. Zhu 2 , Q. Wang 2 , L. Zhou 2 . 1 Nanjing Medical University, Nanjing, China; 2 The First Affiliated Hospital of Nanjing Medical University, Nanjing, China Background: Pulmonary arterial hypertension (PAH) is a fatal complication of connective tissue diseases (CTDs). Chest CT has been increasingly used in the evaluation of patients with suspected PH noninvasively but there is a paucity of studies.…”

Section: Ab1139mentioning

confidence: 99%

Ab1137 classification of the Early Stage of Rapidly Destructive Coxopathy According to the Femoral Head Destruction

et al. 2020

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Background:Rapidly destructive coxopathy (RDC) is an unusual subset of osteoarthritis of the hip characterized by rapid chondrolysis with progressive loss of the joint space as the first manifestation of the disease. Because rapid progression of RDC makes it difficult to obtain sequential radiographs in its early stage, the process of disease progression in the early stage remains unclear. Although the pathogenesis of RDC is still unclarified, the potential causes of RDC include subchondral insufficiency fracture of the femoral head resulting from osteoporosis, pelvic posterior inclination in RDC as a mechanical factor, and increased serum levels of matrix metalloproteinase (MMP)-3 as a biological factor.Objectives:This study aimed to differentiate the process of disease progression in the early stage of RDC and provide its new classification system.Methods:This monocentric retrospective study included 42 female patients who met the criteria of RPOH, chondrolysis >2 mm during 12 months from the onset of hip pain based on a series of radiographs and computed tomography (CT). This study also included 9 female patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH), who demonstrated chondrolysis >2 mm during 12 months from the onset of hip pain. Cortical thickness index (CTI) correlated with bone mineral density of the hip, pelvic tilt, and serum concentrations of matrix metalloproteinase (MMP)-3 were analyzed.Results:RDC were classified into two types based on the absence (type 1, n=17) and presence (type 2, n=25) of subsequent femoral head destruction shown by CT within 12 months after the onset of hip pain. MMP-3 significantly increased in RDC type 2 compared with type 1 and DDH. Increased posterior pelvic tilt was found in RDC type 2 compared with DDH. Logistic regression and receiver operating characteristic curve analyses indicated that MMP-3 may be associated with differentiation between RDC types 1 and 2. No difference was found in CTI between RDC types and DDH.RDC type 2 hips developed partial (type 2A) and massive (type 2B) femoral head destruction within the first 12 months. Whereas partial destruction showed <20% collapse ratio, massive destruction demonstrated >40% collapse ratio. Increased posterior pelvic tilt was found in massive destruction. Femoral head destruction started earlier within the first 6 months in massive destruction compared with that in partial destruction. From receiver operating characteristic curve analysis, pelvic tilt differentiated the femoral head destruction types using the initial radiograph at the onset before first demonstration of femoral head destruction. No difference was found in CTI or MMP-3 between the two subtypes.Conclusion:Disease progression of RDC during 12 months after the onset of hip pain could be classified into two distinct types based on the absence (type 1) and presence (type 2) of femoral head destruction in association with MMP-3 and pelvic tilt as biological and mechanical factors, respectively. MMP-3 may be helpful to differentiate those two types in the early stage of RPOH. The extent of femoral head destruction could further differentiate RDC type 2 into two subtypes based on pelvic tilt.Acknowledgments :This study was supported by the Japan Hip Joint Foundation.Disclosure of Interests:None declared

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Clinical and Echocardiographic Predictors of Outcomes in Patients With Pulmonary Hypertension

Cited by 23 publications

References 25 publications

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

Role of biomarkers in evaluation, treatment and clinical studies of pulmonary arterial hypertension

Ab1137 classification of the Early Stage of Rapidly Destructive Coxopathy According to the Femoral Head Destruction

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