A history of thrombectomy was independently associated with a significantly increased risk of echocardiographically suspected pulmonary hypertension (OR 2.450) in maintenance hemodialysis patients.
Cross-Sectional (n=948)
No
Echocardiographically suspected pulmonary hypertension affects approximately 30% of maintenance hemodialysis patients and is independently associated with left-sided cardiac remodeling and a history of severe vascular access interventions.
Odds Ratio: 2.45 (95% CI 1.249–4.807)
p-value: p=0.009
Pulmonary hypertension (PH) is a prevalent complication in maintenance hemodialysis (MHD) patients, contributing to increased cardiovascular morbidity. This study aimed to determine the prevalence and independent risk factors for echocardiographically suspected PH in a Chinese MHD cohort. This single-center retrospective cross-sectional study reviewed 948 MHD patients who underwent transthoracic echocardiography between January 2023 and December 2024. Suspected PH was consistently defined using standardized objective echocardiographic criteria (estimated pulmonary artery systolic pressure > 35 mmHg), with qualitative right-heart markers serving as supportive criteria only when tricuspid regurgitant jets were unmeasurable. Following rigorous data cleaning to remove extreme outliers, a prespecified multivariable logistic regression model—adjusted for core clinical confounders—was used to identify independent predictors. The prevalence of echocardiographically suspected PH was 29.7% (282/948). Patients with suspected PH had significantly lower hemoglobin (107.48 ± 23.70 vs. 113.10 ± 23.93 g/L, p = 0.001) and serum albumin (41.79 ± 5.22 vs. 43.03 ± 4.40 g/L, p < 0.001), alongside markedly higher median brain natriuretic peptide levels (414.30 IQR: 132.46–1466.23 vs. 124.25 IQR: 50.30–338.54 pg/mL, p < 0.001). After multivariable adjustment for age, sex, diabetes, hypertension, and dialysis vintage, independent predictors included larger left atrial diameter (OR 1.292, 95% CI 1.223–1.364, p < 0.001), lower left ventricular ejection fraction (OR 0.954, 95% CI 0.927–0.981, p = 0.001), history of thrombectomy (OR 2.450, 95% CI 1.249–4.807, p = 0.009), and history of percutaneous transluminal angioplasty (PTA) (OR 1.511, 95% CI 1.014–2.250, p = 0.042). Echocardiographically suspected PH affects approximately 30% of Chinese MHD patients. It is significantly and independently associated with left-sided cardiac remodeling and a history of severe vascular access interventions.
Jiang et al. (Mon,) conducted a cross-sectional in Maintenance hemodialysis (n=948). History of thrombectomy vs. No history of thrombectomy was evaluated on Echocardiographically suspected pulmonary hypertension (estimated pulmonary artery systolic pressure >35 mmHg) (OR 2.450, 95% CI 1.249-4.807, p=0.009). A history of thrombectomy was independently associated with a significantly increased risk of echocardiographically suspected pulmonary hypertension (OR 2.450) in maintenance hemodialysis patients.