Abstract 4140630: Serum Metabolites Predict Mortality or Transplant in Pre-capillary and Combined Pre- and Post-capillary Pulmonary Hypertension in the PVDOMICS Cohort

• DOI: 10.1161/circ.150.suppl_1.4140630
• Publication Date: 2024-11-14T06:27:23Z
• Authors: Matthew Dreier; Samuel Chung; Alexandra Racanelli; Jonathan Chacon-B...; Evelyn Horn
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Introduction: Efforts to stratify mortality risk in pulmonary hypertension (PH) have focused on the minority of patients WSPH group 1. Metabolomic studies 1 identify histidine, polyamines, tRNA metabolites, and homoarginine as predictors mortality. Little is known about role metabolomics predict larger PH patients. Question: Which serum metabolites a composite or transplant pre-capillary, post-capillary, combined pre- post-capillary (Cpc-PH), irrespective group? Aims: To predictive Pulmonary Vascular Disease Phenomics Program (PVDOMICS) cohort understand pathobiology relating mortality/transplant. Methods: We generated peripheral venous metabolomic data 649 subjects. defined pre-capillary vascular resistance (PVR)>2 WU capillary wedge pressure (PCWP)≤15 mmHg (n = 453), PVR≤2 PCWP>15 (n=25), Cpc-PH PVR>2 171). used Cox models with multiple testing correction each group. then correlated select hemodynamic, laboratory, echocardiographic data. Results: The hemodynamic groups included mix groups. identified 249 PH, 0 7 Cpc-PH. Homoarginine predicts mortality/transplant (HR=0.56, p<0.001) (HR=0.59, p=0.025). In low associated high PVR (r=-0.26, p<0.001), BNP (r=-0.49, RV dilation (p<0.001 for moderately dilated, p<0.001 severely dilated vs. normal), free wall longitudinal strain (r=-0.31, p<0.001). Conclusions: Many Cpc-PH, including those previously well newly predictors. our knowledge, this first report such subsets rather than Our suggest contributes increased PVR, failure, PH. More are needed.