Prediction of Life Expectancy in Patients with Primary Pulmonary Hypertension. A Retrospective Nationwide Survey from 1980-1990.

Abstract

Primary pulmonary hypertension (PPH) is a progressive disease of unknownetiology usually followed by death within 5 years after diagnosis. Although heart-lung or lung transplantation is nowoffered to patients with advancedPPH,adequate criteria assessing an accurate prediction of life expectancy in PPHhas been difficult to establish. The aims of this study were to identify the characteristic features associated with a poor prognosis in patients with PPH, and to attempt to establish an individual prognostic index that predicts with great accuracy survival or death ofPPH after one year, thereby helping to define criteria for patient selection for transplantation. In 1991, a retrospective nation-wide survey on PPHwas conducted in Japan, and the clinical and cardiorespiratory variables of223 PPH cases (female; 144, male; 79) in the period from 1980-1990 were obtained. The mean pulmonary arterial pressure (Ppa) was 57.5 ± 17.2 mmHg(mean ± SD), and the overall median survival time was 32.5 months since the first diagnostic catheterization. The characteristic features of 61 patients who died within one year of catheterization (Nonsurvivors group) were compared to 141 patients whosurvived one year or more from the time of catheterization (Survivors group). Amongseveral clinical and cardiorespiratory variables, heart rate, Ppa, right atrial pressure (Pra), stroke volume index (SI), pulmonary vascular resistance, and partial pressure of carbon dioxide (PaCO2) were significantly different between the two groups. As the independent factors, Ppa, Pra, SI, and PaCO2were selected for the multiple logistic analysis. Using a 0.7 probability cut-point to separate Nonsurvivors from Survivors, 84.6% of Nonsurvivors and Survivors could be correctly predicted from this logistic regression equation. Predictive equations like the present preliminary one can be used in the future to better assess life expectancy in patients with PPHin whomtransplantation will be considered. (Internal Medicine 38: 12-16, 1999)

Efficacy of Bosentan in a Small Cohort of Adult Patients With Pulmonary Arterial Hypertension Related to Congenital Heart Disease

“…In the present study, bosentan therapy significantly reduced RAP and mPAP, two hemodynamic parameters that are closely associated with survival in other forms of PAH, 31,32 and it did so with few adverse events, particularly with no evidence of systemic desaturation or worsening volume overload. It is unclear why saturations did not similarly increase in our study as in the study by Christensen et al, 18 but may reflect the low number of patient observations obtained in this earlier investigation.…”

Assessment and Prognostic Relevance of Right Ventricular Contractile Reserve in Patients With Severe Pulmonary Hypertension

“…by guest on May 10, 2018 http://circ.ahajournals.org/ Downloaded from 69%, and 48% compared with patients of group 2 with rates of 96%, 92%, and 89% (P=0.002; Figure 4A). The 1-, 3-, and 4-year survival rates for all patients were 94%, 80%, and 67%, respectively ( Figure 4A).…”

“…4,39,42,43 From these parameters, an equation to predict a patient's likelihood of survival has been created. 4 However, this equation is based on patients with idiopathic and heritable Log-rank test P values, continuous variables were classified in low ≤ median and high > median.…”

Estimación auscultatoria de la presiónsistólica de arteria pulmonar: ¿Es factible?. Correlación con determinación ecocardiográfica

“…En pacientes con hipertensión pulmonar primaria la magnitud de la elevación de la presión sistólica de arteria pulmonar (PSAP), especialmente en ausencia de reversibilidad, se asocia a un pronós-tico desfavorable 2 . En pacientes con insuficiencia cardíaca crónica tanto isquémica como idiopática también constituye un predictor independiente de mortalidad 3,17 .…”