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Echoing the Need for Oxygen in CTEPH
Session:
Sessão de Posters 27 - Abordagem e avanços terapêuticos na hipertensão pulmonar
Speaker:
Tiago Lobão
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.4 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Tiago Lobão; Sofia Alegria; Filipa Ferreira; Débora Repolho; Ana Claúdia Vieira; Bárbara Ferreira; Paula Fazendas; Lourenço Aguiar; Diogo Cunha; Liliana Brochado; Adriana Silva; Hélder Pereira
Abstract
<p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Introduction: </span></span><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by elevated pulmonary artery pressure due to persistent obstruction by fibrotic material. In patients with resting hypoxemia (PaO2 < 60 mmHg), long-term oxygen therapy (LTOT) is indicated. Transthoracic echocardiography (TTE)-derived pulmonary artery systolic pressure (PASP) is widely used to screen for pulmonary hypertension, but its ability to predict LTOT requirement in CTEPH remains unclear.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Purpose: To evaluate whether TTE-derived PASP predicts the need for long-term oxygen therapy in patients with CTEPH</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Methodology: We conducted a retrospective study of patients with confirmed CTEPH who initiated follow-up between 2015 and 2023. Baseline data were collected. Patients were considered on LTOT if oxygen was prescribed during follow-up. Group differences were assessed using the t-test. Associations between pulmonary artery systolic pressure (PASP) and LTOT were evaluated with univariate logistic regression, followed by multivariate logistic regression adjusting for age and NT-proBNP. ROC curves assessed PASP’s discriminatory ability and optimal cut-off using Youden’s index.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Results: Among 64 patients, 24 (37%) required long-term oxygen therapy (LTOT). The cohort was predominantly female (64%), median age of 66 years (IQR 54–75). Mean PASP was 79.8 ± 30.7 mmHg, median NT-proBNP 888 pg/mL (IQR 243–2200), and 65% were in NYHA class III. PASP was significantly higher in the LTOT group (67.7 vs 99.8 mmHg; p <0.001). In univariate logistic regression, higher PASP was associated with increased odds of LTOT (OR 1.049, 95% CI 1.02–1.08; p < 0.001). ROC analysis showed good discriminatory ability (AUC 0.803, 95% CI 0.695–0.911; p<0.001). The optimal cut-off was PASP ≥ 80 mmHg (87.5% sensitivity, 67.5% specificity), with 14.5-fold higher odds of LTOT (OR 14.5, 95% CI 3.7–57.7; p < 0.001). In a multivariate model including NT-proBNP and age, PASP remained associated with LTOT need (p=0.04; OR 1.045, 95% CI 1.014–1.077).</span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Conclusion: In this CTEPH patient cohort, higher PASP was associated with the need for oxygen therapy. Each 1 mmHg increase in PASP increased the odds of needing LTOT by 4.5%. A PASP threshold of ≥ 80 mmHg was associated with a 14.5-fold increase in the likelihood of LTOT need and provided good sensitivity. These findings suggest that TTE-derived PASP may help identify patients that need LTOT.</span></span></p>
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