Baseline right ventricular end-diastolic elastance >0.53 mmHg·mL(-1) was associated with worse clinical progression in pulmonary arterial hypertension (age-corrected HR 0.27, p=0.02).
Observational (n=123)
Is right ventricular diastolic stiffness associated with clinical progression in patients with pulmonary arterial hypertension?
Right ventricular diastolic stiffness is associated with clinical progression and survival in patients with pulmonary arterial hypertension, with intrinsic myocardial changes playing a role in advanced stages.
Hazard Ratio: 0.27
p-value: p=0.02
Right ventricular (RV) diastolic stiffness is increased in pulmonary arterial hypertension (PAH) patients. We investigated whether RV diastolic stiffness is associated with clinical progression and assessed the contribution of RV wall thickness to RV systolic and diastolic stiffness. Using single-beat pressure-volume analyses, we determined RV end-systolic elastance (Ees), arterial elastance (Ea), RV--arterial coupling (Ees/Ea), and RV end-diastolic elastance (stiffness, Eed) in controls (n=15), baseline PAH patients (n=63) and treated PAH patients (survival >5 years n=22 and survival 0.53 mmHg·mL(-1) associated with worse prognosis (age-corrected hazard ratio 0.27, p=0.02). In treated patients, Eed was higher in patients with survival 5 years (0.91±0.50 versus 0.53±0.33 mmHg·mL(-1), p5 years were not different from control values (0.76±0.47 versus 0.60±0.41 mmHg·mL(-1), respectively, not significant), whereas in patients with survival 5 years survival, but not in those surviving <5 years. This suggests that intrinsic myocardial changes play a distinctive role in explaining RV diastolic stiffness at different stages of PAH.
Trip et al. (2015) conducted an observational in Pulmonary arterial hypertension (n=123). Right ventricular end-diastolic elastance (Eed) >0.53 mmHg·mL(-1) vs. Eed ≤0.53 mmHg·mL(-1) was evaluated on Clinical progression (worse prognosis) (HR 0.27, p=0.02). Baseline right ventricular end-diastolic elastance >0.53 mmHg·mL(-1) was associated with worse clinical progression in pulmonary arterial hypertension (age-corrected HR 0.27, p=0.02).