Impact of left heart disease risk factors on risk stratification and treatment response in pulmonary arterial hypertension
| العنوان: | Impact of left heart disease risk factors on risk stratification and treatment response in pulmonary arterial hypertension |
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| المؤلفون: | Dominic Keating, E Kotlyar, Edmund M.T. Lau, Nathan Dwyer, Rachael Cordina, K. Kearney, Melanie Lavender, Trevor Williams, David S. Celermajer, R. Weintraub, Anne Keogh, Helen Whitford, K. Whyte, James Anderson, Nicholas Collins |
| المصدر: | European Heart Journal. 42 |
| بيانات النشر: | Oxford University Press (OUP), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Treatment response, business.industry, Internal medicine, Risk stratification, Cardiology, Medicine, Left heart disease, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background Contemporary registries have documented a change in the epidemiology of PAH patients displaying increasing co-morbidities associated with left heart disease (LHD). These patients are often excluded from randomized clinical trials. It is unclear whether the presence of LHD comorbidities may adversely impact the accuracy of risk stratification and response to PAH therapy. Method Data was extracted from the Pulmonary Hypertension Society of Australia and New Zealand registry for incident patients with a diagnosis with idiopathic/heritable/toxin-induced (I/H/D)-PAH and connective tissue disease (CTD) associated PAH from 2011 - 2020. Patients without available medication and follow up data were excluded. We used the AMBITION trial exclusion criteria to define the subpopulation with LHD risk factors and haemodynamic phenotype (PAH-rLHD). Results 489 patients (I/H/D-PAH=251, CTD-PAH=238) were included in our analysis, with 103 (21.0%) fulfilling the definition of PAH-rLHD (34 had ≥3 risk factors for left heart disease (rLHD-hypertension, diabetes, obesity or ischaemic heart disease) and 76 had borderline haemodynamics (mean capillary wedge pressure 13–15 with pulmonary vascular resistance Conclusion Despite lower PVR at diagnosis, PAH-rLHD patients and “classical” PAH demonstrate similar response to first-line therapy with similar long term survival. The REVEAL 2.0 risk score can be effectively applied to the subpopulation of PAH-rLHD in real life clinical practice. Funding Acknowledgement Type of funding sources: None. |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::04532c90ff92299b25794d123b16d3ad https://doi.org/10.1093/eurheartj/ehab724.1958 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........04532c90ff92299b25794d123b16d3ad |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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