SESSION TITLE: Pulmonary Hypertension (Poster Discussion)
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Limited literature exists on the relation of nutritional status of patients with Pulmonary Arterial Hypertension (PAH) to severity of PAH and whether it affects their functional status.Whether severity of PAH affects nutritional status has not been studied. The objective of this study wasmto determine whether nutritional status as measured by Lean Body Mass (LBM), Body Mass Index (BMI), Percent of Ideal Body Weight (%IBW), serum albumin (SAlb) and hemoglobin (Hb) affects the functional capacity ( assessed by 6-minute walk distance [6MWD] and NYHA class) and mean pulmonary artery pressure (mPAP) in PAH patients.
METHODS: The medical records of 82 patients with PAH being followed at the pulmonary hypertension center in our institution were reviewed. The following data was obtained from records -(i) Weight, height, SAlb, Hb, 6MWD and NYHA class at the initial evaluation.(ii) mPAP, Pulmonary Vascular Resistance (PVR) at the initial right-heart catheterization. BMI, LBM and %IBW was calculated from height and weight, using appropriate formulas. The presence of a significant correlation between BMI, LBM, %IBW, S albumin and Hb with mPAP, NYHA class and 6MWD, respectively, was determined by analysis of variance.
RESULTS: Seventy-five percent patients were females. Studied parameters are as follows: Mean mPAP was 42.3 ±13 mmHg; mean PVR was 577±376 dynes/sec/cm5. Mean NYHA class was 3 (range 1-4). Mean BMI was 28.24 ± 7 kg/sqm; mean LBM was 47.3±9 kg; mean %IBW was 127 ±34%. Mean Hb was 12.6±1 gm/dl. Mean Albumin was 3.5 ±0.6gm/dl. Mean 6MWD was 350 ±117 meters. On analysis of covariance, BMI, LBM and %IBW had a significant association with mPAP: the higher these indices, the higher the mPAP. LBM had a significant correlation with 6MWD but not NYHA class. %IBW and BMI had no significant effect on 6MWD or NYHA class. Hb and SAlb had no significant correlation with mPAP or 6MWD. SAlb had a significant correlation with NYHA class.
CONCLUSIONS: Some parameters of nutritional condition, such as indices of body weight, affect severity and functional status in PAH.Obesity, as manifested by higher BMI and %IBW, was associated with a higher mPAP and more severe disease but did not significantly affect functional status of patients with PAH. Serum albumin levels and LBM appear to be significantly related to functional status.
CLINICAL IMPLICATIONS: Studies are needed to evaluate the role of obesity as a risk factor and prognostic factor in PAH.
DISCLOSURE: The following authors have nothing to disclose: Julianne Nichols, Shiela Zanoria, Diahann Wilcox, D. Datta, Raymond Foley
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