TY - JOUR T1 - Hemodynamic and clinical relevance of "borderline pulmonary hypertension" JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2626 AU - Gabor Kovacs AU - Alexander Avian AU - Vasile Foris AU - Maria Tscherner AU - Andrea Olschewski AU - Horst Olschewski Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2626.abstract N2 - The clinical relevance of borderline mean pulmonary arterial pressure (mPAP: 21-24mmHg) is not entirely clear.We retrospectively analyzed hemodynamic measurements at rest and during exercise of patients with resting mPAP<25mmHg. Patients with “borderline hemodynamics” were compared to those with mPAP≤20mmHg. In addition, the hemodynamics of our patients were compared to historic controls from the literature.We included n=141 patients (borderline: n=32). Borderline patients were older (65.8±12.5yr vs. 57.3±12.5yr, p=0.001) and had more often an underlying cardiac (53% vs. 15%, p<0.001), or pulmonary disease (47% vs. 16%, p<0.001). After correction for age, borderline patients had higher pulmonary vascular resistance (216±59 vs. 141±60dyn s cm-5, p<0.001), pulmonary artery wedge pressure (9.6±3.2 vs. 6.8±2.5mmHg, p<0.001), and NT-proBNP (653±1062 vs. 188±234pg/ml, p=0.05), lower peak oxygen uptake (16.9±4.6 vs. 20.9±4.7ml/min/kg, p=0.009) and lower six-minute walk distance (383±120 vs. 448±92m, p=0.001). The increase of mPAP from rest to exercise was steeper in borderline patients (p=0.006) compared to patients with resting mPAP≤20mmHg. In the compliance vs. resistance curve, both groups and historic controls were represented on the same hyperbola, where patients with borderline hemodynamics were characterized by the highest resistance and lowest compliance values and historic controls with the lowest resistance and highest compliance values.Patients with “borderline PH” represent a distinct group of patients with higher resistance, lower compliance and decreased exercise capacity compared to patients with resting mPAP≤20mmHg. Borderline PH is often associated with a mild respiratory or left heart disease. ER -