A cross-sectional study of pulmonary arterial hypertension in congenital heart disease by right heart catheterization

Abstract

To explore the prevalence of pulmonary arterial hypertension (PAH) in congenital heart disease (CHD) and analyze its independent risk factors. During May 2007 to December 2008, a total of 704 consecutive CHD patients initially admitted into Fuwai Hospital were recruited. Their baseline data were collected and right heart catheterization (RHC) was performed. Those with a mean pulmonary arterial pressure (mPAP) ≥ 25 mmHg (1 mmHg = 0.133 kPa) during RHC were diagnosed as PAH. Multiple Logistic regression was performed to analyze the independent risk factors of PAH. There were 319 males and 385 females with a median age of 5 years. The causes included atrial septal defect (n = 185), ventricular septal defect (VSD, n = 452), patent ductus arteriosus (PDA, n = 48) and a combinations of the above lesions (n = 19). And 280 (39.8%) CHD patients had PAH. Logistic regression analysis revealed that age, systemic artery systolic blood pressure, VSD, PDA and combined lesions were independent risk factors of PAH in CHD (age: OR = 1.017, 95%CI: 1.001-1.033, P = 0.040; systemic artery systolic blood pressure: OR = 0.959, 95%CI: 0.944-0.975, P < 0.001; VSD: OR = 4.402, 95%CI: 2.615-7.411, P < 0.001; PDA: OR = 6.417, 95%CI: 3.079-13.373, P < 0.001; combined lesions: OR = 10.513, 95%CI: 3.641-30.355, P < 0.001). PAH is a common complication of CHD. Age, peripheral artery systolic blood pressure and type of lesion are independent risk factors of PAH in CHD.