Abstract
Introduction: In contrast to the systemic arterial system, the association between age and compliance in the pulmonary circulation has to date not been investigated in vivo. The aim of this study was to evaluate the impact of age on pulmonary arterial compliance in health and in patients with pulmonary arterial hypertension (PAH).
Methods: Consecutive patients with No PH (mPAP<25mmHg) and PAH underwent magnetic resonance imaging (MRI) and right heart catheterisation (RHC). Main pulmonary arterial compliance was measured by a combined MRI and RHC approach (area change of the main pulmonary artery/pulse pressure (PP)) and RHC only approach (stroke volume/PP) in patients. Compliance was estimated in healthy volunteers by a computational modeling of pulmonary arterial phase contrast MRI data.
Results: 151 patients with PAH (57 underwent follow up RHC), 83 patients with No PH were identified and 34 healthy volunteers were included. Main pulmonary artery compliance correlated with age in patients with No PH (r=0.491, p<0.001) and PAH (r=0.251, p<0.001). Non-invasively derived compliance correlated with age in healthy volunteers (r=-0.560, p<0.001). At multivariate analysis, age was independently associated with compliance (p<0001). In younger patients (<50 years), pulmonary arterial compliance increased on PAH therapy (p<0.0001), older patients on PAH therapy showed no significant increase (p=0.206).
Discussion: Advancing age is independently associated with pulmonary arterial compliance in health and disease. In contrast to younger patients, pulmonary arterial compliance does not increase in response to PAH therapy in older patients.
- Copyright ©the authors 2016