Pulmonary Vascular Disease |

Clinical Outcome of PH Patients Referred to a Tertiary Care Pulmonary Vascular Center FREE TO VIEW

Brietta Forbes, MD; Sonia Castillo, MD; Lewis Satterwhite, MD; Leslie Spikes, MD; Timothy Williamson, MD
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University of Kansas, Merriam, KS

Chest. 2015;148(4_MeetingAbstracts):955A. doi:10.1378/chest.2271629
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SESSION TITLE: Pulmonary Arterial Hypertension Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Every year many patients are referred to a Pulmonary Vascular Center for evaluation of suspected pulmonary hypertension (PH). Only a fraction are diagnosed with PH; an even smaller fraction meet criteria for Pulmonary Arterial Hypertension (PAH). It is thought that some patients would benefit from pulmonary vasodilator therapy despite not meeting traditional criteria for PAH. The purpose of this study is to evaluate the outcome of patients treated with pulmonary vasodilator therapy at a tertiary care Pulmonary Vascular Center.

METHODS: We retrospectively reviewed 182 consecutive cases of patients referred to the University of Kansas Pulmonary Vascular Center with suspected PH between 2012 and 2014. We calculated the prevalence of pulmonary hypertension and pulmonary arterial hypertension. We compared the change in six-minute walk test (6MWT) before and after initiation of therapy in patients with PH compared to patients with PAH. Statistical analysis was performed using SPSS version 22.

RESULTS: RESULTS Upon review, 105 of 182 patients were confirmed to have PH (57.7%). 32 of the 182 patients met strict criteria for WHO Group I PAH (17.6%). Pulmonary vasodilator therapy was started in 51 of the 182 patients reviewed (28%). Clinical improvement was defined as an increase in the six-minute walk test (6MWT) six months after initiation of therapy. The mean percent change in 6MWT before and after initiation of therapy was 65.8 in the group that met criteria for PAH vs. -4 in the group that did not meet criteria for PAH (p=0.47).

CONCLUSIONS: Only a minority of patients met traditional criteria for PAH in this retrospective study. Clinical improvement was observed in patients who met criteria for PAH and were treated with pulmonary vasodilator therapy as compared to patients who did not meet criteria for PAH and were treated with pulmonary vasodilator therapy. This was evident in the mean percent change in 6MWT before and after initiation of therapy, though the results were not statistically significant.

CLINICAL IMPLICATIONS: While pulmonary vasodilator therapy is approved for PAH, many of the patients presenting to PH referral centers do not fit criteria for PAH. However PH specialists are prescribing these medications for reasons that deserve more inquiry. Further investigation into treatment of PH patients without PAH is needed to address the larger population of patients referred to PH centers for definitive management.

DISCLOSURE: The following authors have nothing to disclose: Brietta Forbes, Sonia Castillo, Lewis Satterwhite, Leslie Spikes, Timothy Williamson

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