Key result
Mild echocardiographic pulmonary hypertension is linked to ~32% higher mortality and increased RV dysfunction.
Why the study?
Current guidelines recommend evaluating for RVSP greater than 40 mm Hg, but this threshold does not capture all patients at risk, leaving uncertain whether mild echocardiographic pulmonary hypertension is associated with reduced RV function and increased mortality.
Does mild echocardiographic pulmonary hypertension increase mortality and reduce right ventricular function in patients referred for echocardiography?
Population
47 784 patients referred for echocardiography with recorded RVSP estimates at a medical center
Comparison
Mild ePH (RVSP 33 to 39 mm Hg) vs no ePH or RVSP less than 33 mm Hg
Design
Cohort study
Authors
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Mild ePH on echocardiography may warrant closer monitoring; leaves open whether current RVSP thresholds need revision pending prospective data.
Cohort (n=47,784)
No
Does mild echocardiographic pulmonary hypertension increase mortality and reduce right ventricular function in patients referred for echocardiography?
Effect estimate: HR 1.32 (95% CI 1.02-1.70)
Mild echocardiographic pulmonary hypertension (RVSP 33-39 mm Hg) is associated with worse RV function and increased mortality, suggesting the current guideline threshold of >40 mm Hg may miss at-risk patients.
Huston et al. (2019) conducted a cohort in Mild echocardiographic pulmonary hypertension (n=47,784). Mild echocardiographic pulmonary hypertension (RVSP 33-39 mm Hg) vs. No echocardiographic pulmonary hypertension (RVSP < 33 mm Hg) was evaluated on Mortality (HR 1.32, 95% CI 1.02-1.70). Mild echocardiographic pulmonary hypertension was associated with increased mortality (HR 1.32 at RVSP 27 mm Hg; 95% CI 1.02-1.70) and higher prevalence of RV dysfunction (32.6% vs 16.7%; P<0.001).
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