P2-4 - Clinical Background in Patients With Pulmonary Hypertension Due to Left Heart Disease

Abstract

Background: Pulmonary hypertension (PH) is a relevant complication of left heart disease (LHD). The 2015 ESC/ERS PH guidelines report two different hemodynamic phenotypes of PH due to LHD (PH-LHD) based on pulmonary vascular resistance (PVR) and diastolic pressure gradient (DPG): isolated post-capillary PH (Ipc-PH) and combined post- and pre-capillary PH (Cpc-PH). The objective of this study is to reveal the clinical characterics of Ipc-PH and Cpc-PH. Methods and Results: Among 184 consecutive chronic heart failure patients (averaged age: 64 y.o) who underwent right heart catheterization in our hospital, 62 patients (34%) were identified as PH-LHD. According to the guidelines, Ipc-PH is defined by DPG <7 mmHg and/or PVR ≦ 3 WU and Cpc-PH by DPG ≧ 7 mmHg and/or PVR > 3 WU. Using this definition, we identified three patient groups: Ipc-PH with both normal PVR and DPG (34 pts); Cpc-PH with both increased PVR and DPG (6 pts); and an intermediate group with either increased PVR or DPG (22 pts). Patients with Cpc-PH and the intermediate group had significantly higher mean PA pressure (40 ± 9 vs 31 ± 5 mmHg, P < .001) and lower SvO2 (60 ± 5 vs 69 ± 7%, P < .001) and lower cardiac output compared with the group of patients with Ipc-PH. LVEF in Cpc-PH and the intermediate group tend to be lower than Ipc-PH. Conclusion: Patients with Cpc-PH and the intermediate group have severe clinical background than those with Ipc-PH.