TY - JOUR T1 - Hemodynamics, exercise capacity and clinical events in pulmonary arterial hypertension JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/09031936.00123712 SP - erj01237-2012 AU - Gianluigi Savarese AU - Francesca Musella AU - Carmen D'Amore AU - Teresa Losco AU - Caterina Marciano AU - Paola Gargiulo AU - Giuseppe Rengo AU - Santo Dellegrottaglie AU - Eduardo Bossone AU - Dario Leosco AU - Pasquale Perrone-Filardi Y1 - 2012/01/01 UR - http://erj.ersjournals.com/content/early/2012/10/25/09031936.00123712.abstract N2 - Purpose of this study was to clarify whether changes in cardiopulmonary hemodynamics induced by pharmacologic therapy correlate with exercise capacity and clinical events in patients with pulmonary arterial hypertension.Sixteen randomized trials including 2,353 patients, followed up for 16.4±10.6 weeks, measuring cardiopulmonary hemodynamics by right heart catheterization and reporting clinical events were included. Meta-analysis and meta-regression analysis were performed to assess the effects of treatments on clinical events and the relationship between hemodynamic (pulmonary artery pressure, pulmonary vascular resistance, cardiac index and right atrial pressure) changes and clinical events.Treatments significantly reduced all-cause death (odds ratio [OR]:0.5; 95% confidence interval [IC]:0.3 to 0.7; p<0.01), hospitalization for pulmonary arterial hypertension (OR:0.4; IC:0.2 to 0.7; p<0.01), initiation of rescue therapy (OR:0.3; IC:0.2 to 0.6; p<0.01) and the composite outcome (OR:0.3; IC:0.3 to 0.5; p<0.01). No relationship was found between changes of hemodynamic parameters and clinical events, whereas changes of cardiac index and pulmonary vascular resistance significantly correlated with changes of 6 minute walking distance (r=0.64, p=0.03; r= −0.55; p=0.04 respectively).In patients with pulmonary arterial hypertension, improvements of cardiopulmonary hemodynamics, observed in randomized clinical trials, correlate with exercise capacity changes but do not predict clinical events in a short-term follow up. ER -