Depressed right ventricular systolic function (p=0.04) and elevated pulmonary artery systolic pressure (p=0.03) on baseline echocardiogram were associated with increased 5-year mortality in SSc-PH.
Observational (n=32)
No
Do baseline echocardiographic parameters predict 5-year mortality in patients with systemic sclerosis-associated pulmonary hypertension?
Depressed right ventricular systolic function and elevated pulmonary artery systolic pressure on baseline echocardiogram are associated with increased 5-year mortality in patients with systemic sclerosis-associated pulmonary hypertension.
p-value: p=0.04
Abstract Rationale Prevalence of pulmonary hypertension (PH) in patients with Systemic Sclerosis(SSc) is estimated to be as high as 19% and responsible for 30% mortality in this population. While ECHO has been shown to be important for screening and determining which of these patients should proceed to right heart catheterization, it has not been well studied which echo parameters may be predictive of outcomes in SSc PH patients. Other studies have shown parameters such as pericardial effusion, indexed right atrial area, degree of septal shift during diastole, and tricuspid annular systolic excursion to be associated with mortality or transplantation. Because SSc affects the ability of the heart to remodel, it is unclear if these observations apply to this specific patient population. Methods Performed a retrospective review of SSc patients enrolled in the UNMC PH database who have been diagnosed with PH per the PH guidelines (mPAP 20 and PVR 2 WU on RHC). 32 patients were in the database with baseline echo data available. Parameters including right atrial size, estimated PASP, presence of pericardial effusion, right ventricular size, right ventricular systolic function (S’), right ventricular end diastolic area (RVEDA), and if there was presence of flattened septum was compared to a 5-yearmortality rate. Results Chi-squared testing demonstrated statistically significant association between 5-year mortality and right ventricular systolic function (depressed vs normal; χ²(1, N = 26) = 4.24, p = 0.04). There was no significant associations between 5-year mortality and the presence of right atrial dilation (χ²(1, N = 26) = 2.6, p = 0.10), pericardial effusion (χ²(1, N = 27) = 0.01, p = 0.90), or a flattened septum (χ²(1, N = 27) = 0.01, p = 0.90)One-way ANOVA testing revealed a significant association between 5-year mortality and pulmonary artery systolic pressure (F = 5.64, p = 0.03), but not with right ventricular size (F = 1.59, p = 0.21), right ventricular systolic function (F = 3.26, p = 0.08), or right ventricular end-diastolic area (F = 1.12, p = 0.31). Conclusions Our study demonstrated an association with increased 5-year mortality when depressed RV systolic function or elevated PASP was present on baseline echo in PH SSc patients. This information can help risk stratify these patients and identify those who are at higher risk of mortality in the coming years. This abstract is funded by: None
C Coles (Fri,) conducted a observational in Systemic Sclerosis-associated Pulmonary Hypertension (n=32). Baseline echocardiography was evaluated on 5-year mortality (p=0.04). Depressed right ventricular systolic function (p=0.04) and elevated pulmonary artery systolic pressure (p=0.03) on baseline echocardiogram were associated with increased 5-year mortality in SSc-PH.