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. 2023 Nov 19;13(11):2225.
doi: 10.3390/life13112225.

Temporal Trends in Diagnostic Hemodynamics and Survival of Patients with Pulmonary Hypertension: A Single-Center Study

Georgios E Papadopoulos  1 , Alexandra Arvanitaki  1 , Eleftherios Markidis  1 , Sophia Anastasia Mouratoglou  1 , Ioannis T Farmakis  1 , Panagiotis Gourgiotis  1 , Thomas Chrysochoidis Trantas  1 , Christos Feloukidis  1 , Antonios Kouparanis  1 , Matthaios Didagelos  1 , Vasilis Grosomanidis  1 , Antonios Ziakas  1 , George Giannakoulas  1
Affiliations

Temporal Trends in Diagnostic Hemodynamics and Survival of Patients with Pulmonary Hypertension: A Single-Center Study

Georgios E Papadopoulos et al. Life (Basel). .

Abstract

Advances in the diagnosis and treatment of pulmonary hypertension (PH) have gradually improved the disease course. This retrospective cohort study aims to explore the diagnostic hemodynamic profile and survival of PH patients and their temporal changes, as well as investigate potential prognostic factors. Overall, 257 adult patients were diagnosed with PH following right heart catheterization (RHC) from January 2008 to June 2023 according to the hemodynamic cut-off values proposed by the corresponding ESC/ERS guidelines at the time RHC was performed. Of these patients, 46.3% were Group 1, 17.8% Group 2, 14.0% Group 3, 18.0% Group 4, and 3.0% Group 5 PH. Temporal improvement in both diagnostic hemodynamic profile and survival of patients with PH and pulmonary arterial hypertension (PAH) was identified after 2013. Survival analysis demonstrated 5-year survival rates of 65% in Group 1 PH (90.3% in idiopathic PAH) and 77% in Group 4 PH. PAH patients being at low risk at diagnosis presented a similar 1-year all-cause mortality rate (12.4%) with high-risk ones (12.8%), primarily due to non-PH-related causes of death (62%), while high-risk patients died mostly due to PH (67%). The observed improvements in diagnostic hemodynamic profiles and overall survival highlight the importance of timely diagnosis and successful treatment strategies in PH.

Keywords: diagnosis; hemodynamics; prognosis; pulmonary arterial hypertension; pulmonary hypertension; right heart catheterization; risk stratification; survival; temporal changes.

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Conflict of interest statement

G.G. has received fees for lectures and/or consultations from Actelion/Janssen, Bayer, Boehringer-Ingelheim, ELPEN Pharmaceuticals, Ferrer-Galenica, GlaxoSmithKline, Gossamer-Bio, MSD, Pfizer, Lilly, and United Therapeutics. G.P., A.A., E.M., S.M., I.F., P.G., T.C., C.F., A.K., M.D., V.G. and A.Z. report no conflict of interest.

Figures

Figure 1
Figure 1
Hemodynamic data variance over time in PH and PAH patients. All hemodynamic variables significantly improved between the 2008–2013 and 2013–2018 periods and remained improved in 2018–2023. Abbreviations: mPAP: mean Pulmonary Artery Pressure, PVR: Pulmonary Vascular Resistance, CO: Cardiac Output, PH: Pulmonary Hypertension, PAH: Pulmonary Arterial Hypertension.
Figure 2
Figure 2
The 1-year and 3-year survival temporal trends in PH and PAH patients. Abbreviations: PH: Pulmonary Hypertension, PAH: Pulmonary Arterial Hypertension.
Figure 3
Figure 3
Survival analysis of the PAH patients for the entire cohort and PAH subgroups. Overall, 5-year mortality was 65% (green dashed line). CHD-PAH patients showed the better 5-year survival rate, 81.3%. Abbreviations: PAH: Pulmonary Arterial Hypertension, CTD-PAH: Connective Tissue Disease associated Pulmonary Arterial Hypertension, IPAH: Idiopathic Pulmonary Arterial Hypertension, CHD-PAH: Congenital Heart Disease associated Pulmonary Arterial Hypertension, PoPH: Portal Pulmonary Hypertension.
Figure 4
Figure 4
Survival analysis of the PAH patients among the different risk groups. Abbreviation: PAH: Pulmonary Arterial Hypertension.
Figure 5
Figure 5
Survival analysis of PAH and CTEPH patients. Abbreviations: PAH: Pulmonary Arterial Hypertension, CTEPH: Chronic Thromboembolic Pulmonary Hypertension.
See this image and copyright information in PMC

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