Response by Tello et al to Letter Regarding Article, “Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension”

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute respiratory distress syndrome (ARDS) at high altitude (n=43). Intervention: Severe hypoxemia (PaO2/FiO2 < 165.13 mm Hg) vs. PaO2/FiO2 ≥ 165.13 mm Hg. Primary outcome: Pulmonary artery hypertension (PAH) secondary to ARDS (OR 15.455, 95% CI 1.075-222.174, p=0.044).

Q: What does this research mean for the field?

In high-altitude settings, pulmonary artery hypertension occurs in approximately 44.2% of patients with ARDS, with severe hypoxemia (PaO2/FiO2 < 165.13 mm Hg) serving as a significant independent risk factor. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Khodr Tello; Hossein Ardeschir Ghofrani; Werner Seeger; Manuel Jonas Richter; Robert Naeije

doi:10.1161/circimaging.119.010059

November 1, 2019Circulation Cardiovascular Imaging

Response by Tello et al to Letter Regarding Article, “Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension”

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Why the study?

The prevalence and mechanisms of pulmonary arterial hypertension secondary to ARDS in high-altitude areas and its impact on right ventricular function were not well characterized.

Study Design

Type

Observational (n=43)

Multicenter

No

PICO

P

Population

43 adult patients with ARDS requiring mechanical ventilation at a high-altitude ICU, evaluated for secondary pulmonary hypertension and followed for 28 days.

E

Exposure / Comparator

Severe hypoxemia (PaO2/FiO2 < 165.13 mm Hg) vs PaO2/FiO2 ≥ 165.13 mm Hg

O

Primary Outcome

Pulmonary artery hypertension (PAH) secondary to ARDS — OR 15.455 (1.075-222.174), p=0.044

Main Result

Odds Ratio: 15.455 (95% CI 1.075–222.174)

p-value: p=0.044

Limitations

Small sample size, limiting epidemiological conclusions.
Potential unidentified comorbid diseases that could have affected pulmonary arterial pressure.
Use of cardiac ultrasonography rather than the gold-standard Swan-Ganz catheter for assessing pulmonary arterial pressure.
Lack of real-time continuous evaluation of pulmonary artery pressure and right heart function.

Abstract

SCOPUS: le.j

Discussion

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Cite This Study

Tello et al. (2019) conducted an observational in Acute respiratory distress syndrome (ARDS) at high altitude (n=43). Severe hypoxemia (PaO2/FiO2 < 165.13 mm Hg) vs. PaO2/FiO2 ≥ 165.13 mm Hg was evaluated on Pulmonary artery hypertension (PAH) secondary to ARDS (OR 15.455, 95% CI 1.075-222.174, p=0.044).

synapsesocial.com/papers/6ac9c92ffda6ccf93902ff83 https://doi.org/10.1161/circimaging.119.010059

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Response by Tello et al to Letter Regarding Article, “Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension”

Study Design

PICO

Main Result

Limitations

Abstract

Discussion

Cite This Study

Response by Tello et al to Letter Regarding Article, “Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension”

Study Design

PICO

Main Result

Limitations

Abstract

Discussion

Cite This Study

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