RT Journal Article SR Electronic T1 Clinical relevance of right ventricular diastolic stiffness in pulmonary hypertension JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP OA3522 DO 10.1183/13993003.congress-2015.OA3522 VO 46 IS suppl 59 A1 Pia Trip A1 Silvia Rain A1 Louis Handoko A1 Cathelijne Van der Bruggen A1 Harm Jan Bogaard A1 Tim Marcus A1 Anco Boonstra A1 Nico Westerhof A1 Anton Vonk Noordegraaf A1 Frances De Man YR 2015 UL http://erj.ersjournals.com/content/46/suppl_59/OA3522.abstract AB Aim: Right ventricular (RV) diastolic-stiffness is increased in pulmonary arterial hypertension (PAH) patients. We investigated whether RV diastolic-stiffness is associated with clinical progression and assessed the contribution of RV wall-thickness to RV systolic and diastolic-stiffness.Methods: Using single-beat pressure-volume-analyses, we determined RV end-systolic-elastance (Ees), arterial-elastance (Ea), RV-arterial-coupling (Ees/Ea), and RV end-diastolic-elastance (stiffness,Eed) in controls (n=15), baseline PAH (n=63) and treated PAH-patients (survival>5 years, n=22, and survival<5 years, n=23).Results: We observed an association between Eed and clinical progression, with baseline Eed>0.53 mmHg/ml associated with worse prognosis (age-corrected hazard-ratio 0.27, p=0.02). In treated patients, Eed was higher in patients with survival<5 years than in patients with survival>5 years (0.91±0.50 vs. 0.53±0.33 mmHg/ml, p<0.01)Wall-thicknesscorrected Eed-values in PAH-patients with survival>5 years were not different from control values (0.76±0.47 vs. controls 0.60±0.41 mmHg/ml, ns), whereas in patients with survival<5 years, values were significantly higher (1.52±0.91 mmHg/ml, p<0.05 vs. controls).Conclusions: RV diastolic-stiffness is related to clinical progression in both baseline and treated PAH patients. RV diastolic-stiffness is explained by the increased wall-thickness in patients with >5years survival, but not in <5years survival patients. This suggests that intrinsic myocardial changes play a distinctive role in explaining RV diastolic-stiffness in different PAH stages.