Abstract 19137: Association of Pulmonary Hypertension and Left Ventricular Dysfunction: Impact of Demographics

Abstract

The association between left ventricular diastolic dysfunction (LVDD) and pulmonary hypertension (PH) is shown in the literature, studies on the linear association between LVDD and PH severity and effect of demographics on this association are lacking. We aimed to investigate the correlation of LVDD with presence and/or severity of PH and to examine whether patient’s demographics modifies this association. Methods: Study population included 2702 randomly selected patients with ejection fraction (EF) ≥ 50%, who presented to the echocardiographic lab at a tertiary care academic center between 2008 and 2011. Diastolic function was assessed based on echocardiographic characteristics. PH was diagnosed if right ventricle systolic pressure (RSVP) was ≥ 40 mmHg. Using logistic regression analysis, the association between diastolic function and presence and severity of PH was examined after adjusting for potential demographic and clinical confounders. Then, we examined the interaction term of demographics (age, sex and combination of age and sex) in regards to the association between LVDD and PH. Results: Among 2702 patients, 1301 (48.4%) were female, 842 (31.2%) had normal LVDD and 694 (25.7%) had PH. Patients with LVDD had higher frequency of PH compared to those with normal diastolic function (28.1% vs. 18.6%, OR: 1.7; 95%CI: 1.4, 2.1; p< 0.0001). RVSP increases at higher stages of LVDD (p<0.0001). Among patients with LVDD, PH was found in 24.7% patients with impaired relaxation, 44.5% of pseudonormal, and 52.5% of those with restrictive. Subgroup analysis showed that in patients 60 (OR: 1.9 vs. 0.9, p<0.0001 and 0.8820, respectively). Besides, the association of LVDD and PH was higher among female patients < 60, compared to males <60 (OR: 2.5 vs 1.5, p<0.0001 and 0.0800, respectively). Sex did not modify the association between LVDD and PH. Conclusion: Patients with LVDD have higher risk of PH, compared to those patients with normal diastolic function. The severity of PH also increases with higher stages of the LVDD. In addition, these findings were more pronounced in middle age females.