0
Abstract: Poster Presentations |

PREVALENCE AND SIGNIFICANCE OF RESTING PULMONARY HYPERTENSION IN PATIENTS REFERRED FOR EXERCISE STRESS ECHOCARDIOGRAPHY FREE TO VIEW

Garvan C. Kane, MD*; Naser M. Ammash, MD; Jae K. Oh, MD; Thomas Behrenbeck, MD; Patricia A. Pellikka, MD; Robert B. McCully, MD
Author and Funding Information

Mayo Clinic, Rochester, MN


Chest


Chest. 2008;134(4_MeetingAbstracts):p135003. doi:10.1378/chest.134.4_MeetingAbstracts.p135003
Text Size: A A A
Published online

Abstract

PURPOSE: The prevalence of pulmonary hypertension (PH) in patients referred for treadmill stress echocardiography is not well defined.

METHODS: A total of 2,306 patients (exclusions: <18 years, significant valvular disease, a history of coronary artery disease, left ventricular (LV) ejection fraction <50%, and atrial fibrillation/flutter) were evaluated by Bruce protocol treadmill stress echocardiography and Doppler-derived assessment of right ventricular systolic pressure (RVSP). Pulmonary hypertension (PH) was defined as RVSP>35 mm Hg at rest.

RESULTS: PH was present in 275 pts (11.9%). Pts with PH were older (67±13 vs 59±13, p<0.0001); weighed more (BMI 28.7±5 vs 27.7±5, p<0.005), had increased vascular stiffness (pulse pressure 58±18 vs. 50± 15 mmHg, P<0.001) and a greater degree of left atrial enlargement suggesting diastolic dysfunction (67% vs 43%, p<0.0001). E/e’ (a Doppler estimate of left ventricular filling pressure) was also higher (11±4 vs 9±4, p<0.0001). PH was a major predictor of exercise capacity. Exercise duration was significantly reduced in patients with PH (7.1±3 mins) vs those without PH (8.7±3 mins, p<0.0001). This effect persisted after adjusting for age and gender, p<0.0001.

CONCLUSION: PH is present in a significant proportion of patients (11.9%) referred for treadmill stress echocardiography and correlates with impaired exercise capacity. Although likely related to a range of factors, the association of PH with increasing age, diastolic dysfunction and vascular stiffness suggests a predominance of LV diastolic dysfunction-related PH (Group II of the WHO Classification).

CLINICAL IMPLICATIONS: Whether treatment strategies directed at this cohort will affect exercise capacity remains to be seen.

DISCLOSURE: Garvan Kane, None.

Wednesday, October 29, 2008

1:00 PM - 2:15 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543