04 February 2019 by Ümit Sinan

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


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.


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.


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%.


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


About the author

profile picture of Ümit Sinan

Ümit Sinan

Cardiologist, Instructor

Istanbul University Institute of Cardiology


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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