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.
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