Key result
Symmetrical peripheral pulmonary artery pruning was associated with similarly poor survival compared to asymmetrical pulmonary arterial occlusions (26 weeks vs 38 weeks).
Why the study?
Does angiographic classification of unexplained pulmonary hypertension into symmetrical versus asymmetrical patterns predict survival?
Cohort (n=43)
No
Does angiographic classification of unexplained pulmonary hypertension into symmetrical versus asymmetrical patterns predict survival?
In patients with unexplained pulmonary hypertension, angiographic classification into symmetrical or asymmetrical patterns did not correlate with survival, which was uniformly poor.
Angiographic patterns should not guide prognosis in unexplained PH; leaves open whether refined classifications or biomarkers improve risk stratification.
During 1970-87 43 patients with unexplained pulmonary hypertension (mean pulmonary arterial pressure greater than 25 mm Hg) were admitted to the Brompton Hospital and classified by angiographic criteria as having either symmetrical peripheral pulmonary artery pruning (thought to represent primary plexogenic pulmonary arteriopathy), n = 21, or asymmetrical pulmonary arterial occlusions (thought to represent chronic thromboembolic disease), n = 22. Patients with symmetrical pulmonary arteriopathy had significantly higher mean pulmonary arterial pressures (67 mm Hg) at the time of presentation than those with asymmetrical pulmonary arteriopathy (49 mm Hg). Clinical distinction between these two groups was impossible. Survival from the time of diagnosis was similarly poor in the two groups (26 weeks and 38 weeks) and did not correlate with any of the haemodynamic measurements. The difficulties in making distinctions between these conditions are discussed.
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Gray et al. (1990) conducted a cohort in Unexplained pulmonary hypertension (n=43). Symmetrical peripheral pulmonary artery pruning vs. Asymmetrical pulmonary arterial occlusions was evaluated on Survival from the time of diagnosis. Symmetrical peripheral pulmonary artery pruning was associated with similarly poor survival compared to asymmetrical pulmonary arterial occlusions (26 weeks vs 38 weeks).
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