04 February 2019

The increasing prevalence of pre-capillary PH according to new PH definition described on 6th WSPH Congress

Introduction:

From the 1st WSPH (Geneva 1973), pulmonary hypertension has been defined arbitrarily as mean PAP > 25 mmHg measured by right heart catheterization (RHC) in the supine position at rest. On 6th WSPH congress (Nice 2018), it is suggested that pre-capillary PH could be defined as mean PAP >20 mmHg, PAWP <15 mmHg and PVR >3WU. The impact of the new definition of the number of pre-capillary PH patient identified would be low with preliminary data suggesting an increase < 10%. In this study we aimed to investigate the impact of new definition of the number of pre-capillary PH.

Methods:

We screened the RHC performed in our university hospital with various clinical indication between 2017 and 2018. Demographics, clinical indications, hemodynamic data were recorded. Both 2015 ESC/ERS and 6th WSPH congress PH definition were used to define PH patients.

Results:

Fifty-eight RHC was performed in our university in one year period. Most of the procedure was performed with a suspicion of PH. The rest of indications were valvular heart disease, left heart disease and lung disease. There were 40 female (69%) and 18 male (31%) patients. The mean age of study population was 53.3 ± 16.6 years old. On RHC, the mean PAP was 36.4 ± 16.4 mmHg, mean PCWP was 12.6 ± 3.9 mmHg and mean PVR was 4.9 ± 4.4 WU. While 43 of 58 patients (74.1%) were classified as pre-capillary PH according to 2015 ESC/ERS PH guideline, when 6th WSPH congress PH definition was used, 50 of 58 patients (86.2%) had pre-capillary PH. The impact of the new definition was 12.1%.

Conclusion:

The impact of the new definition of the number of pre-capillary PH patient identified was predicted <%10, but our study revealed more prominent increase

 

Key Contributors

Umit Yasar Sinan, MD1, Ozge Cetinarslan, MD1, Alev Arat Ozkan, MD1, Murat Kazım Ersanli, MD1, Mehmet Serdar Kucukoglu, MD1 1 Istanbul University-Cerrahpasa Institute of Cardiology, Department of Cardiology, Istanbul, Turkey


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