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 of each group. Among the medical history variables, only a history of myocardial infarction was more prevalent in the decedents.
As anticipated, among the hemodynamic variables, those reflecting LV function were all significantly related to mortality, including left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). In addition, PAMP pulmonary wedge pressure, pulmonary vascular resistance, and right atrial pressure were all significantly increased among those who died during the follow-up period (p<0.01). buy cheap antibiotics
The interrelationships among the various measures of cardiac structure and function are presented in Table 2. As the most widely used measure of global LV systolic function, LVEF was negatively related to LVEDP, PAMP, and pulmonary wedge pressure (p<0.01). At the same time, LVEDP PAMP and pulmonary wedge pressure were all highly positively intercorrelated (r=0.6 to 0.7; p<0.001). Increasing echo-LV mass and septal wall thickness were associated with a lower LVEF and higher intracardiac pressures.

Table 1—Descriptive Characteristics of Study Cohort: Survivors vs Decedents

Variable Survivors (N = 1268) Decedents (N = 103)
Age, yr 55.2 ±8.8 55.9 ±9.2
Sex, No. %
Male 606 (48) 62t(60)
Female 664 (52) 41 (40)
Race, No. %
Black 965 (76) 87 (84)
White 118 (9) 8 (8)
Other 187 (15) 8 (8)
Medical history, %
Prior MI 27 52$
Diabetes mellitus 27 35
Hypertension 76 79
Ever smoked 56 65
Electrocardiographic LVH, % 25 35t
Angiographic findings:No. (%) of vessels stenosed:
0 606 (47) 23 (22)
1 243 (19) 16 (16)
2 185 (14) 28 (27)
3 236 (20) 36 (35)
Hemodynamic findings, mean ± SD
Aortic mean pressure, mm Hg 103.7 ±16.2 103.7 ±15.8
LVEDP mm Hg 12.8 ±5.8 16.5 ±9.2
LV ejection fraction, % 64.2 ±15.1 54.9 ±16.4
PAMP, mm Hg 19.2 ±7.6 24.7±11.0
Pulmonary wedge pressure,
mm Hg 10.0 ±5.9 14.5 ±7.8
PVR, dyne/s/cm “ 141,8±96.3 184.9 ±108.1
Right atrial pressure, mm Hg 5.8 ±3.0 7.5 ±4.7

Table 2—Correlation Matrix of Measures of Cardiac Structure and Function: Hemodynamic and Echo Variables (N = 1371)

EjectionFraction LVEDP PAMean PulmonaryWedge AorticMean IVSeptum LVMass
Ejection fraction
LVEDP -.316
PAMP -.317 .586
Pulmonary wedge -.370 .693 .685
Aortic mean pressure .103 .048 .160 .057
IV septum .067 -.004 .051 -.003 .209
LV mass -.289 .145 .217 .163 .142 .603*
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