Pulmonary artery pulse pressure as a predictor of pulmonary hypertension in patients with intermediate-high risk pulmonary embolism

Résumé fourni par la source

Pulmonary hypertension (PH) is a recognized long-term complication that can arise after pulmonary embolism (PE). This study aimed to evaluate the predictive power of pulmonary artery pulse pressure (PAPP) for the development of PH and compare it to sPAP (already stablished as a predictor of PH) Patients (P) with intermediate-high risk PE submitted to catheter-directed therapy in a tertiary centre were scheduled for follow-up (FU) to screen for PH after 3–6 month of anticoagulation with right heart catheterization (RHC). PPAP values from RHC during the acute PE episode were collected and analysed to assess their potential as predictive markers for the development of pre-capillary PH (mPAP >20 mmHg, PVR > 2 WU and PCWP < 15 mmHg in RHC). A logistic regression was used to assess the predictive value of PAPP for PH development and then a ROC curve analysis to determine the optimal cut-off threshold for PAPP as a predictor 48 P (median age 63 years) were included. The mean PPAP was 33,4 ± 11,58 mmHg. 23 P (47,9%) were diagnosed with pulmonary hypertension at 3-6 month follow-up. The logistic regression model showed that PPAP was a significant predictor of PH (p=0,017) and the ROC curve analysis demonstrated a superior discriminative power compared to sPAP with an optimal cut-off of 33,5mmHg (Sensitivity 65,2%; Specificity 80%). When employing this threshold, individuals exhibiting elevated PPAP levels demonstrated a 7.5-fold increased likelihood of developing PH (OR = 7.5; p = 0.002) In our study, PPAP at admission demonstrated a higher discriminative power in predicting the development of PH at 3-6 month FU when compared to sPAP.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.