RT Journal Article
SR Electronic
T1 Late Breaking Abstract - Implications of new PH definition for CTEPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1935
DO 10.1183/13993003.congress-2021.PA1935
VO 58
IS suppl 65
A1 Ashwin Reddy
A1 Emilia Swietlik
A1 Lucy Robertson
A1 Alice Michael
A1 Sonja Boyle
A1 Gary Polwarth
A1 Dolores Taboada
A1 Charaka Hadinnapola
A1 John Cannon
A1 Karen Sheares
A1 Mark Toshner
A1 Joanna Pepke-Zaba
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/PA1935.abstract
AB 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.FootnotesCite 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).