Left Ventricular Filling Pressure in Chronic Thromboembolic Pulmonary Hypertension

• DOI: 10.1016/j.jacc.2022.11.049
• Publication Date: 2023-02-13T19:41:35Z
• Authors: Christian Gerges; Anna-Maria Pistritto; Mario Gerges; Richard Friewald; Valerie Hartig; Thomas M. Hofbauer; Benedikt Reil; Leon Engel; Varius Dannenberg; Stefan P. Kastl; Nika Skoro-Sajer; Bernhard Moser; Shahrokh Taghavi; Walter Klepetko; Irene M. Lang
• Keywords: Pulmonary wedge pressure; Preload

Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by obstruction of major arteries with organized thrombi. Clinical risk factors for due to left heart disease including metabolic syndrome, left-sided valvular disease, and ischemic are common in CTEPH patients. The authors sought investigate prevalence prognostic implications elevated ventricular filling pressures (LVFP) CTEPH. A total 593 consecutive patients undergoing a first diagnostic right catheterization were included this study. Mean arterial wedge pressure (mPAWP) end-diastolic (LVEDP) utilized assessment LVFP. Two cutoffs applied identify LVFP: 1) the primary analysis mPAWP and/or LVEDP >15 mm Hg, as recommended current guidelines; 2) secondary >11 representing upper limit normal. echocardiographic features, long-term mortality assessed. LVFP was Hg 63 (10.6%) 222 (37.4%). Univariable logistic regression identified age, systemic hypertension, diabetes, atrial fibrillation, calcific aortic valve stenosis, mitral regurgitation, volume significant predictors Atrial remained independent determinants adjusted analysis. At follow-up, higher LVFPs measured who had meanwhile undergone endarterectomy (P = 0.002). 0.021) 0.006) both associated worse survival. Elevated common, appears be comorbid predicts prognosis