0
Pulmonary Vascular Disease |

Pulmonary Arterial Capacitance Predicts 1-Year Survival but Not Change in 6-Minute Walk Distance in Pulmonary Arterial Hypertension FREE TO VIEW

Nadine Al-Naamani, MD; Nicholas Hill; Ioana Preston
Author and Funding Information

Tufts Medical Center, Boston, MA


Chest. 2015;148(4_MeetingAbstracts):934A. doi:10.1378/chest.2229190
Text Size: A A A
Published online

Abstract

SESSION TITLE: Predictors of Outcomes in PAH

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 27, 2015 at 08:45 AM - 10:00 AM

PURPOSE: The objective of the study was to determine whether the baseline pulmonary arterial capacitance (PAC) was predictive of change in 6-minute walk distance (6MWD) and survival in a large cohort of pulmonary arterial hypertension (PAH) patients.

METHODS: PAH patients enrolled in the clinical trials of subcutaneous treprostinil and oral beraprost from November 1998 to October 1999 were included in the analysis. PAC was determined as ratio of stroke volume/pulmonary pulse pressure (mL/mm Hg). Correlation between baseline PAC and baseline 6MWD was determined using Spearman’s correlation coefficient. Multivariate linear regression model was used to assess the association between baseline PAC and change in 6MWD at 3 months. Cox regression model was used to assess the association between baseline PAC and survival at 1 year.

RESULTS: 586 patients were included in the final study cohort. Mean age was 44 years, 82% were females and 82% were white. The most common etiology was idiopathic PAH (61%) followed by congenital heart disease (22%). At baseline, the mean 6MWD was 349 meters and the majority of patients were NYHA functional class III. The mean PAC at baseline was 1.1 mL/mm Hg. Baseline PAC was positively correlated with the baseline 6MWD (r=0.13, p=0.003). After adjusting for age, sex, etiology of PAH, baseline 6MWD and NYHA class, baseline PAC was not significantly associated with change in 6MWD at 3 months (β=3.60, p=0.37); however a 1 mL/mm Hg decrease in baseline PAC value was associated with 2.78 fold increase in 1-year mortality (HR=2.78, p=0.01).

CONCLUSIONS: Baseline PAC was associated with survival in patients with PAH but not with change in 6MWD at 3 months.

CLINICAL IMPLICATIONS: Baseline PAC is predictive of 1-yr survival and may be an informative biomarker in the assessment of PAH patients. There is no clinically significant relationship between baseline PAC and the 6MWD at baseline or at 3-month follow-up.

DISCLOSURE: Nicholas Hill: Consultant fee, speaker bureau, advisory committee, etc.: Bayer, Grant monies (from industry related sources): Ikaria, Grant monies (from industry related sources): Reata, Consultant fee, speaker bureau, advisory committee, etc.: Actelion, Consultant fee, speaker bureau, advisory committee, etc.: Gilead Ioana Preston: Consultant fee, speaker bureau, advisory committee, etc.: United Therapeutics, Grant monies (from industry related sources): United Therapeutics, Consultant fee, speaker bureau, advisory committee, etc.: Gilead, Consultant fee, speaker bureau, advisory committee, etc.: Actelion, Consultant fee, speaker bureau, advisory committee, etc.: Bayer The following authors have nothing to disclose: Nadine Al-Naamani

No Product/Research Disclosure Information


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.

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