PURPOSE: A single institution referral center for Pulmonary Arterial Hypertension(PAH) generated an electronic database retrospectively of patients that had undergone a right heart catheterization (RHC) to facilitate quality improvement, education, and research.
METHODS: The electronic medical record(EMR) was queried for all subjects who had undergone RHC. The subjects were reviewed with demographic characteristics, associated comorbidities, hemodynamic parameters, pulmonary function tests, pharmacologic and non-pharmacologic therapies, toxicity monitoring, functional class and six minute walk distance. A prospective arm was also initiated and is currently ongoing.
RESULTS: Two hundred fifty-eight consecutive subjects were identified from October 2006 to January 2010. A single staff physician performed all RHC with pulmonary/critical care fellows. The following results were obtained. Male 69(27%); Female 189(73%) subjects. Age range 17-91. Mean age 61.2 years. Subjects with a mean pulmonary artery pressure(mPAP) > 25 mm Hg, a mean pulmonary capillary wedge pressure(mPCWP) < 15 mm Hg, and peripheral vascular resistance(PVR) > to 240 dynes···s···cm-5 equaled 102 subjects. The majority were idiopathic PAH, familial PAH, and connective tissue diseases. The subjects with a mPAP >25 and a PCWP >18 were patients with cardiomyopathies, diastolic heart failure, and mitral regurgitation. The average cardiac output(CO) by thermodilution was 4.76 L/min, and average CO by Fick was 5.03 L/min. A vasodilator challenge was performed (76/258) 29%. An exercise challenge was performed (44/258) 17 %. The average DlCO was 13.14 (45%). The average RVSP was 52.79 mm Hg. Mortality of subjects in cohort with PAH was 14.7% as determined by EMR review.
CONCLUSION: Data is presented from 258 single physician RHC with prospective enrollment to allow comparison with the REVEAL database. This information will facilitate quality improvement with a standardized format to collect data, empower the clinic nurses in research activity, provide more consistent care of the patients, and foster an avenue for fellow research of PAH, as well as non-group 1 pulmonary hypertension(PH).
CLINICAL IMPLICATIONS: A local PH registry will allow for comparison for performance against the national REVEAL registry.
DISCLOSURE: Marcia Henderson, No Financial Disclosure Information; No Product/Research Disclosure Information