Long-term outcome of patients with combined post- and pre-capillary pulmonary hypertension. 2023

Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, Zurich 8091, Switzerland.

Pulmonary hypertension (PH) is a complex clinical condition, and left heart disease is the leading cause. Little is known about the epidemiology and prognosis of combined post- and pre-capillary PH (CpcPH). This retrospective analysis of the Swiss PH Registry included incident patients with CpcPH registered from January 2001 to June 2019 at 13 Swiss hospitals. Patient baseline characteristics [age, sex, mean pulmonary artery pressure (mPAP), pulmonary artery wedge pressure (PAWP), pulmonary vascular resistance (PVR), and risk factors, including World Health Organization (WHO)-functional class (FC), 6 min walk distance (6MWD), and N-terminal pro-brain natriuretic peptide (NT-proBNP), treatment, days of follow-up, and events (death or loss to follow-up) at last visit] were analysed by Kaplan-Meier and Cox regression analyses. Two hundred and thirty-one patients (59.3% women, age 65 ± 12 years, mPAP 48 ± 11 mmHg, PAWP 21 ± 5 mmHg, PVR 7.2 ± 4.8 WU) were included. Survival analyses showed a significantly longer survival for women [hazard ratio (HR) 0.58 (0.38-0.89); P = 0.01] and a higher mortality risk for mPAP > 46 mmHg [HR 1.58 (1.03-2.43); P = 0.04] but no association with age or PVR. Patients stratified to high risk according to four-strata risk assessment had an increased mortality risk compared with patients stratified to low-intermediate risk [HR 2.44 (1.23-4.84); P = 0.01]. A total of 46.8% of CpcPH patients received PH-targeted pharmacotherapy; however, PH-targeted medication was not associated with longer survival. Among patients with CpcPH, women and patients with an mPAP ≤46 mmHg survived longer. Furthermore, risk stratification by using non-invasively assessed risk factors, such as WHO-FC, 6MWD, and NT-proBNP, as proposed for pulmonary arterial hypertension, stratified survival in CpcPH, and might be helpful in the management of these patients.

UI MeSH Term Description Entries

Related Publications

Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
October 2022, Pneumologie (Stuttgart, Germany),
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
October 2021, Deutsche medizinische Wochenschrift (1946),
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
July 2016, Journal of the American College of Cardiology,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
January 2021, PloS one,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
January 2023, Heart failure reviews,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
January 2017, PloS one,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
February 2019, JACC. Cardiovascular interventions,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
December 2016, Journal of the American College of Cardiology,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
September 2020, Canadian journal of physiology and pharmacology,
Anna Titz, and Laura Mayer, and Paula Appenzeller, and Julian Müller, and Simon R Schneider, and Michael Tamm, and Andrei M Darie, and Sabina A Guler, and John-David Aubert, and Frédéric Lador, and Hans Stricker, and Jean-Marc Fellrath, and Susanne Pohle, and Mona Lichtblau, and Silvia Ulrich
January 2021, Pulmonary circulation,
Copied contents to your clipboard!