Pulmonary Hypertension in Adults With a Systemic Right Ventricle (Biventricular Circulation)

Figures

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  Figure 1. Patient Selection RV = right ventricle.

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  Central Illustration. Pulmonary Hypertension in Patients With a Systemic Right Ventricle Pulmonary hypertension is common in patients with a systemic right ventricle undergoing catheterization and is strongly associated with adverse clinical outcomes. The majority of patients with pulmonary hypertension in this setting have a combined pre and post capillary subtype with a combination of elevated filling pressures and elevated pulmonary vascular resistance. Pulmonary vascular resistance and aortic pulsatility index are predictors of adverse events.

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  Figure 2. Pulmonary Hypertension Subtype According to Diagnosis and PH Severity Chi-square test was used to assess whether frequencies of patients classed by PH type and mean PAP differed by TGA morphology. IpcPH = isolated post capillary pulmonary hypertension; CpcPH = combined precapillary and postcapillary pulmonary hypertension; mPAP = mean pulmonary artery pressure; PA = pulmonary artery; PH = pulmonary hypertension; TGA-AS = transposition of great arteries palliated with atrial switch repair.

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  Figure 3. Scatterplot of mPAP vs PCWP by Diagnosis (Line of Best Fit and 95% Error Margins) CCTGA = congenitally corrected transposition of the great arteries; PCWP = pulmonary capillary wedge pressure; other abbreviations as in Figure 2.

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  Figure 4. Freedom From Primary Endpoint According to Morphology and PH/PVR (A) Freedom from primary endpoint according to diagnosis and pulmonary HT. (B). Freedom from primary endpoint according to diagnosis and PVR. MCS = mechanical circulatory support; PVR = pulmonary vascular resistance; TGA = transposition of great arteries; other abbreviations as in Figures 2 and 3.

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  Figure 5. Multivariable Analysis for Predictors of Primary Outcome (HR for Death/Transplant/MCS) API = aortic pulsatility index; CPI = cardiac power index; PAC = pulmonary artery compliance; other abbreviations as in Figures 2, 3, and 4.