Dissemin is shutting down on January 1st, 2025

Published in

Karger Publishers, Respiration, 8(101), p. 717-727, 2022

DOI: 10.1159/000524263

B51. SUNSET: GROUP 3 PULMONARY HYPERTENSION, 2022

DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a5632

Links

Tools

Export citation

Search in Google Scholar

The Effect of Borderline Pulmonary Hypertension on Survival in Chronic Lung Disease

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Green circle
Postprint: archiving allowed
Red circle
Published version: archiving forbidden
Data provided by SHERPA/RoMEO

Abstract

<b><i>Background:</i></b> The impact of the new “borderline” hemodynamic class for pulmonary hypertension (PH) (mean pulmonary artery pressure [mPAP], 21–24 mm Hg and pulmonary vascular resistance, [PVR], ≥3 wood units, [WU]) in chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) is unclear. <b><i>Objectives:</i></b> The aim of this study was to assess the effect of borderline PH (BLPH) on survival in COPD and ILD patients. <b><i>Method:</i></b> Survival was analyzed from retrospective data from 317 patients in 12 centers (Italy, Spain, UK) comparing four hemodynamic groups: the absence of PH (NoPH; mPAP &#x3c;21 mm Hg or 21–24 mm Hg and PVR &#x3c;3 WU), BLPH (mPAP 21–24 mm Hg and PVR ≥3 WU), mild-moderate PH (MPH; mPAP 25–35 mm Hg and cardiac index [CI] ≥2 L/min/m<sup>2</sup>), and severe PH (SPH; mPAP ≥35 mm Hg or mPAP ≥25 mm Hg and CI &#x3c;2 L/min/m<sup>2</sup>). <b><i>Results:</i></b> BLPH affected 14% of patients; hemodynamic severity did not predict survival when COPD and ILD patients were analyzed together. However, survival in the ILD cohort for any PH level was worse than in NoPH (3-year survival: NoPH 58%, BLPH 32%, MPH 28%, SPH 33%, <i>p</i> = 0.002). In the COPD cohort, only SPH had reduced survival compared to the other groups (3-year survival: NoPH 82%, BLPH 86%, MPH 87%, SPH 57%, <i>p</i> = 0.005). The mortality risk correlated significantly with mPAP in ILD (hazard ratio [HR]: 2.776, 95% CI: 2.057–3.748, <i>p</i> &#x3c; 0.001) and notably less in COPD patients (HR: 1.015, 95% CI: 1.003–1.027, <i>p</i> = 0.0146). <b><i>Conclusions:</i></b> In ILD, any level of PH portends worse survival, while in COPD, only SPH presents a worse outcome.