Clinical Characteristics and Prognostic Factors of Patients with Severe Pulmonary Hypertension

ABSTRACT

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the clinical characteristics and predictors of the prognosis for patients with severe pulmonary hypertension (PHT). SUBJECTS AND METHODS: A total of 169 patients with severe PHT (systolic pulmonary arterial pressure > or =70 mmHg by Doppler echocardiogram) were divided into two groups according to the mortality during 2.8+/-2.2 year clinical follow-up period group I (moribund group, 34 patients, 60.0+/-15.7 years, 18 males) and group II (survived group, 135 patients, 57.2+/-16.9 years, 65 males). The clinical, electrocardiographic and echocardiographic variables were analyzed. RESULTS: The three most common etiologies were valvular heart disease (VHD)(n=55 32.9%), pulmonary thromboembolism (n=29 17.2%) and ischemic cardiomyopathy (n=17 10.1%). The common presenting clinical symptoms were dyspnea on exertion, leg edema, cough and chest discomfort. Among the variables, the WHO functional classification at presentation [95% confidence interval (CI) 2.065-221.168, p=0.010], atrial fibrillation (AF)(95% CI 1.014-10.161, p=0.041) and the left ventricular ejection fraction (LVEF)(95% CI 1.011-4.545, p=0.047) were significantly associated with the prognosis. CONSLUSION VHD was the most common cause of severe PHT. The WHO functional classification at presentation, the presence of AF and low LVEF at presentation were the significant predictors of mortality for patients with severe PHT.