A novel echocardiography nomogram improved prediction of all-cause death in severe CLD-PH compared with PASP alone, yielding an integrated discrimination improvement of 15.5% (95% CI 5.52-25.5%, p=0.002).
Cohort (n=100)
No
Does an echocardiography nomogram improve prediction of all-cause death compared to PASP alone in patients with severe chronic lung disease-associated pulmonary hypertension?
A novel echocardiography nomogram incorporating PASP, TAPSE, and RV end-diastolic transverse dimension significantly improves mortality prediction over PASP alone in patients with severe CLD-PH.
Effect estimate: IDI 15.5% (95% CI 5.52-25.5%)
p-value: p=0.002
Severe pulmonary hypertension in chronic lung diseases (severe CLD-PH) differs significantly from other types of PH in physiology and prognosis. We aimed to assess whether echocardiography helps predict long-term survival in patients with severe CLD-PH. This single-centre, observational cohort study enrolled 100 patients with severe CLD-PH (mean pulmonary arterial pressure ≥35 mm Hg or ≥25 mm Hg with cardiac index <2.0 L/min/m2 or pulmonary vascular resistance ≥6 Wood units) between 2009 and 2014. The population was randomly divided into a derivation and validation cohort in a 2:1 ratio. To construct a nomogram, a multivariable logistic regression model was applied, and scores were assigned based on the hazard ratio of independent echocardiographic predictors. Multivariate Cox hazards analysis identified the strongest predictors of mortality as pulmonary arterial systolic pressure (PASP), tricuspid annular plane systolic excursion, and right ventricular end-diastolic transverse dimension. The three independent predictors were entered into the nomogram. Compared with PASP alone, the nomogram resulted in an integrated discrimination improvement of 15.5% (95% confidence interval, 5.52−25.5%, p = 0.002) with a net improvement in model discrimination (C-statistic from 0.591 to 0.746). Using echocardiographic parameters, we established and validated a novel nomogram to predict all-cause death for patients with severe CLD-PH.
Jiang et al. (Mon,) conducted a cohort in Severe pulmonary hypertension in chronic lung diseases (severe CLD-PH) (n=100). Echocardiography nomogram vs. PASP alone was evaluated on All-cause death (IDI 15.5%, 95% CI 5.52-25.5%, p=0.002). A novel echocardiography nomogram improved prediction of all-cause death in severe CLD-PH compared with PASP alone, yielding an integrated discrimination improvement of 15.5% (95% CI 5.52-25.5%, p=0.002).