Open AccessAn updated meta‐analysis of hemodynamics markers of prognosis in patients with pulmonary hypertension due to left heart disease
Author(s) -
Baratto Claudia,
Caravita Sergio,
Soranna Davide,
Dewachter Céline,
Bondue Antoine,
Zambon Antonella,
Badano Luigi P.,
Parati Gianfranco,
Vachiéry JeanLuc
Publication year - 2022
Publication title -
pulmonary circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 40
ISSN - 2045-8940
DOI - 10.1002/pul2.12145
Subject(s) - medicine , cardiology , hemodynamics , vascular resistance , hazard ratio , pulmonary hypertension , confidence interval , pulmonary artery , heart failure , population , etiology , compliance (psychology) , psychology , social psychology , environmental health
Pulmonary hypertension (PH) is associated with a poor prognosis in left heart disease (LHD). We sought to provide an updated analysis on the association of hemodynamic variables, such as pulmonary vascular resistance (PVR), pulmonary artery compliance (PAC), and diastolic pressure gradient (DPG), with prognosis in PH‐LHD, through a systematic literature review. Sixteen articles were identified, including 9600 patients with LHD, heterogeneous in terms of age, sex, and etiology of cardiac disease. In this large population, PVR (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.05−1.0), DPG (HR, 1.02; 95% CI: 1.01−1.02) and PAC (HR, 0.76; 95% CI: 0.69−0.84) were associated with an increased risk of adverse outcome, albeit with a less solid performance of DPG. Similar results were found when hemodynamic variables were analyzed according to the thresholds commonly applied in clinical practice, or subdividing cohorts according to the underlying LHD. Furthermore, cumulative metanalysis indicated that these results are consistently stable since 2018. Thus, PVR, DPG and PAC have an established prognostic value in PH‐LHD. These results are consistent through the years and unlikely to change with further studies.