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07. Syncope and Bradycardia
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32. Cardiovascular Nursing
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Long-term survival outcomes and baseline hemodynamics in patients with PAH versus CTEPH
Session:
Posters (Sessão 3 - Écran 6) - Hipertensão pulmonar
Speaker:
Joana Mesquita Guimarães
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.7 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Joana Guimarães; Diogo Fernandes; Gonçalo Costa; Eric Monteiro; Gustavo Campos; João Rosa; Ana Rita Gomes; Rafaela Fernandes; Vanessa Lopes; Cátia Ferreira; Graça Castro; Lino Gonçalves
Abstract
<p>Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are two of the pulmonary hypertension key subgroups and in fact correlated with an adverse prognosis.</p> <p> </p> <p>Purpose: The aim of our study is to compare the effect of baseline hemodynamics on long term survival in incident PAH patients and CTEPH patients.</p> <p> </p> <p>Methods: Between January of 2009 and January of 2020, all incident PH cases were consecutively enrolled in a prospective cohort study. Patients were divided in 2 groups: PAH patients versus CTEPH patients. Clinical data and hemodynamic parameters were collected at baseline and during follow-up. Multivariate logistic regression test and Kaplan-Meier survival analysis were used.</p> <p> </p> <p>Results: A total of 177 patients were followed up for a median of 5.0 [IQR 2.3–8.7] years. The PAH group were younger (mean age 43.9±19.8 vs 61.8±14.5, p<0,001) and had more female patients (72% vs 53.8%, p=0,02). There was no difference in NYHA functional class and 6MWD between groups. Overall, five-year survival was 82.5% and was similar in PAH and CTEPH patients (81.6% vs 84.6%, p=0,83). CTEPH patients had lower mean pulmonary artery pressure (mPAP) (49±13 vs 56±20 mmHg, p=0.02) but higher right atria pressure (RAP) (9±5 vs 7±4 mmHg, p=0.006), higher pulmonary capillary wedge pressure (PCWP) (13±6 vs 10±5 mmHg, p=0.004) and lower cardiac index (CI) (2.15±0.79 vs 2.76±1.42, p=0,009). However, none of these hemodynamic parameters had an impact on mortality at 5 years.</p> <p> </p> <p>Conclusion: In this cohort of incident PH patients, the overall 5-year survival rate was 82.5%. Despite having worse hemodynamic parameters at baseline, CTEPH patients had similar five-year survival to PAH patients.</p>
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