Why the study?
Although echocardiography is important in follow-up, WHO functional class, 6-minute walk distance, and NT-proBNP are the strongest prognostic markers in precapillary pulmonary hypertension, prompting investigation into their relationship with echocardiographic indices.
Standard and advanced echocardiographic indices of right ventricular structure and function correlate significantly with functional status and NT-proBNP levels in patients with precapillary pulmonary hypertension, supporting their utility in clinical practice.
Echo parameters may associate with functional status and NT-proBNP in precapillary PH; leaves open their added prognostic value.
Introduction/Aim While echocardiography plays an important role in the follow-up of patients with precapillary pulmonary hypertension (PH), several studies have identified World Health Oganization's functional class (WHO FC), 6-minute walk distance (6MWD) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as the strongest prognostic markers. We investigated the relationship between echocardiographic indices, functional status and NT-proBNP in patients with precapillary PH. Material and Methods A total of 23 patients were included in this retrospective study. Data were collected from routine risk assessments, including WHO FC, 6MWD, NT-proBNP, standard, strain and three-dimensional echocardiography. The echocardiographic data were analysed in terms of the patients' functional status as determined by WHO FC, 6MWD and NT-proBNP values. Results Patients in WHO FC III or IV had a shorter 6MWD [180 (interquartile range 85-240 m)] than patients in WHO FC I or II [409 (interquartile range 364-494 m), p=0.02)], while the difference in NT-proBNP was not statistically significant [FC I or II: 1297 (interquartile range 283-3196) versus FC III or IV: 343 (interquartile range 274-598) pg/ml, p=0.146]. There were inverse correlations between 6MWD and left and right ventricular longitudinal strain and a direct correlation between 6MWD and pulmonary acceleration time (r=0.73; p=0.001). NT-proBNP measurements were directly correlated with right heart dimensions and right ventricular strain and inversely correlated with pulmonary acceleration time (r=-0.70; p=0.004). Conclusion Standard and advanced echocardiographic indices of right ventricular structure, function and hemodynamics correlate with functional status and natriuretic peptide levels in a heterogeneous cohort of patients with precapillary PH and may be useful ancillary parameters in clinical practice.
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Stanković et al. (2023) studied this question.
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