Abstract
Background Pulmonary arterial hypertension (PAH) is a rare disease of cardiopulmonary circulation
characterized by elevated pressure in the pulmonary artery. The right-heart catheter
is the gold standard for diagnosis, but there is interest in identifying additional
prognostic indicators. The aim of this study was to examine the importance of the
rate of pressure change of the pulmonary artery (dP/dt mean PA) in patients with PAH.
Methods We retrospectively analyzed data from 142 patients with PAH (exclusively clinical
group 1) and examined the statistical correlation of dP/dt mean PA with vascular,
right ventricular, and clinical parameters. Data was collected mostly from the right
heart catheterization and the transthoracal echocardiography at presentation.
Results dP/dt mean PA showed a significant correlation with systolic pressure of the pulmonary
artery (n= 142, R
2 = 56%, p < 0.001), pulmonary vascular resistance (n = 142, R
2 = 51%, p < 0.001), the rate of pressure change in the right ventricle (n = 142, R
2 = 53%, p < 0.001), and the right ventricular fractional area change (n = 110, R
2 = 51%, p < 0.001). Receiver operating characteristic curve analysis showed that dP/dt mean
PA had the highest prognostic value in predicting increase in the 6-minute walk test
and decrease in the N-terminal-probrain natriuretic peptide after the initiation of
PAH therapy, with an area under the curve of 0.73.
Conclusion Our findings suggest that dP/dt mean PA may be a useful prognostic indicator in the
treatment of patients with PAH, and further research is warranted to validate this
parameter.
Keywords
pulmonary hypertension - 6-minute walk test - pulmonary artery
