Archive for the ‘Pulmonary function’ Category - Part 10

Elevated Pulmonary Artery Pressure: Discussion (Part 2)

The weak predictive power of LVEF within the normal range is perhaps not surprising; however, its insensitivity among patients with significant disease raises a series of interesting and important questions. It would appear that the loss of cardiac pump function that generates the risk of dying is not linearly related to systolic function and reflects […]

Elevated Pulmonary Artery Pressure: Discussion (Part 1)

The data presented herein demonstrate that among a cohort of patients with a high prevalence of hypertension and LVH, important prognostic information was contained in the measurement of the hemodynamics of the pulmonary circulation. Across a wide spectrum of functional and structural cardiac abnormalities, pulmonary pressure appeared as the strongest predictor of mortality, entirely independent […]

Elevated Pulmonary Artery Pressure: Results (Part 6)

The coexistence of both high LV mass and high PAMP carried a fivefold increase in mortality risk. The interaction between elevated pulmonary pressure and LVH was further examined by introducing a cross-product term (PA mean X LV mass) into the Cox regression model (Table 6). This term was highly significant in the univariate and multivariate […]

Elevated Pulmonary Artery Pressure: Results (Part 5)

As noted, an important challenge of the analysis procedures applied to these data was to parcel out the separate impact of the various physiologic measures. Given the multicolinearity observed among the measures of cardiac structure and function demonstrated in Table 3, a series of subanalyses were undertaken to define the independent effect of each factor. […]

Elevated Pulmonary Artery Pressure: Results (Part 4)

To determine whether the predictive value of PAMP was relevant in patients with normal coronary arteriograms, further Cox regression analyses were carried out in this subgroup. (At baseline, 629 patients had normal coronary arteries and 23 fatal events were recorded during the follow-up period.) Pulmonary artery mean pressure was found to be the only hemodynamic […]

Elevated Pulmonary Artery Pressure: Results (Part 3)

These findings further demonstrate that pulmonary vascular resistance was not a key contributing factor in the prediction of mortality. Given the low predictive value of these variables, and their elimination from the stepwise model, they were not included in subsequent analyses. Inclusion of LV mass in a multivariate regression model yielded independent significance for PAMP, […]

Elevated Pulmonary Artery Pressure: Results (Part 2)

The major focus of this analysis was to assess the predictive value of right-sided hemodynamic measurements independent of systolic LV function and the severity of coronary atherosclerosis. For this purpose, LVEF was taken as a measure of LV systolic function and Cox regression models were constructed to estimate the relative contribution of pulmonary hemodynamics to […]

Elevated Pulmonary Artery Pressure: Results (Part 1)

The descriptive characteristics of the entire cohort of 1,371 patients, survivors compared with decedents, are presented in Table 1. Most of the patients were blacks while the proportion of male sex was higher among patients who died. Hypertension was common in both groups and electrocardiographic (ECG) evidence of LVH was present in almost one third […]

Elevated Pulmonary Artery Pressure (Part 7)

The key challenge faced in the analysis of these data was the application of statistical procedures to demonstrate the independent prognostic information provided by the measurement of pulmonary artery pressure. Given the high degree of colinearity observed among the various physiologic measures of cardiac structure and function performed as part of this study, multivariate techniques […]

Elevated Pulmonary Artery Pressure (Part 6)

Patients who were not contacted and confirmed to be alive and who were not matched to a death certificate were considered alive as of the last date included in the National Death Index file, namely, December 31,1986. Copies of death certificates were obtained for decedents and served as the sole source of information for assigning […]

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