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Late Breaking Abstract - Implications of new PH definition for CTEPD

Ashwin Reddy, Emilia Swietlik, Lucy Robertson, Alice Michael, Sonja Boyle, Gary Polwarth, Dolores Taboada, Charaka Hadinnapola, John Cannon, Karen Sheares, Mark Toshner, Joanna Pepke-Zaba
European Respiratory Journal 2021 58: PA1935; DOI: 10.1183/13993003.congress-2021.PA1935
Ashwin Reddy
1Royal Papworth Hospital, Cambridge, United Kingdom
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  • For correspondence: ashwin.reddy@cantab.net
Emilia Swietlik
1Royal Papworth Hospital, Cambridge, United Kingdom
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Lucy Robertson
1Royal Papworth Hospital, Cambridge, United Kingdom
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Alice Michael
1Royal Papworth Hospital, Cambridge, United Kingdom
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Sonja Boyle
1Royal Papworth Hospital, Cambridge, United Kingdom
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Gary Polwarth
1Royal Papworth Hospital, Cambridge, United Kingdom
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Dolores Taboada
1Royal Papworth Hospital, Cambridge, United Kingdom
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Charaka Hadinnapola
1Royal Papworth Hospital, Cambridge, United Kingdom
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John Cannon
1Royal Papworth Hospital, Cambridge, United Kingdom
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Karen Sheares
1Royal Papworth Hospital, Cambridge, United Kingdom
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Mark Toshner
1Royal Papworth Hospital, Cambridge, United Kingdom
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Joanna Pepke-Zaba
1Royal Papworth Hospital, Cambridge, United Kingdom
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Abstract

Introduction: In light of the change in diagnostic threshold for pulmonary hypertension (PH) we wished to determine demographic and clinical differences between patients with mPAP <20mmHg and those with mPAP 20-25mmHg at baseline and at 1-year follow-up.

Method: We studied patients diagnosed with chronic thromboembolic pulmonary disease (CTEPD) with mPAP <25mmHg on right heart catheterisation (RHC) between 1/1/2015 and 31/12/2019. Baseline demographics and haemodynamics were compared between those with mPAP <20 and mPAP 20-24mmHg. Pairwise analysis was carried out to determine changes in clinical endpoints at 1-year from baseline. Patients who underwent pulmonary endarterectomy (PEA) in this time were excluded from longitudinal analysis. Mortality was assessed over the entire study period.

Results: 112 patients were recruited; 57 had mPAP <20, 56 had mPAP 20-24. Baseline demographics were similar in both groups with no significant differences noted in echocardiography, 6 minute walk distance (6MWD), NT-pro BNP level and quality of life. Patients with mPAP <20 had lower PVR (127±45 vs 197±75 dynes, p < 0.01) and RVEDP (5.9±2.4 vs 7.8±3.4mmHg, p<0.01). At 1 year no major deterioration was seen in either group. No patients were treated with PH-specific therapy; 8 had undergone PEA. Over median of 38 months follow-up, mortality was 4/57 in the mPAP <20 group and 4/56 in the mPAP 20-24 group. Cause of death was malignancy in 62.5% of cases.

Conclusion: There is no statistical difference in baseline clinical features between CTEPD patients with mPAP <20 and 20-24mmHg, except for PVR and RVEDP. Neither group displayed disease progression at 1 year. However, mortality over 38 months is significant and mainly attributable to malignancy.

  • Embolism
  • Pulmonary hypertension
  • Circulation

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA1935.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Late Breaking Abstract - Implications of new PH definition for CTEPD
Ashwin Reddy, Emilia Swietlik, Lucy Robertson, Alice Michael, Sonja Boyle, Gary Polwarth, Dolores Taboada, Charaka Hadinnapola, John Cannon, Karen Sheares, Mark Toshner, Joanna Pepke-Zaba
European Respiratory Journal Sep 2021, 58 (suppl 65) PA1935; DOI: 10.1183/13993003.congress-2021.PA1935

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Late Breaking Abstract - Implications of new PH definition for CTEPD
Ashwin Reddy, Emilia Swietlik, Lucy Robertson, Alice Michael, Sonja Boyle, Gary Polwarth, Dolores Taboada, Charaka Hadinnapola, John Cannon, Karen Sheares, Mark Toshner, Joanna Pepke-Zaba
European Respiratory Journal Sep 2021, 58 (suppl 65) PA1935; DOI: 10.1183/13993003.congress-2021.PA1935
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