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. Cheap Diskus Advair
First, to control for the effect of the association between worsening severity of pulmonary hypertension and the degree of coronary atherosclerosis, the cohort was stratified by the number of stenosed vessels and univariate comparisons made in PAMP between survivors and decedents (Fig 2). At each level of coronary disease, PAMP was significantly increased among those dying during the follow-up period (p<0.01), and the magnitude of the difference was consistent in each subgroup (approximately 30 percent). Minor increases in PAMP were noted with increasing severity of CAD among the survivors.
Second, since it is likely that increased pulmonary pressure correlates with diastolic dysfunction, we were interested to know if a possible interactive effect on survival existed between LVH—itself a major determinant of LV compliance—and increased PAMP As shown in Table 5, it is evident that increases in pulmonary artery (PA) pressure and LV mass are independently and at least additively related to the risk of dying.
Figure 2. Mean pulmonary artery pressure in survivors and decedents by severity of coronary artery disease (mean and standard deviation).
Table 5—Percentage of Patients Dying during FoUow-up Observation Stratified for the Presence of Pulmonary Hypertension and heft Ventricular Hypertrophy
|Left Ventricular Mass|
|Pulmonary artery||Low||2.6% (6/231)||5.1% (9/157)|
|mean pressure||High||8.6% (12/140)||10.7% (20/187)|