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Comparison of World Health Organization (WHO) Pulmonary Hypertension (PH) Groups I and II

A. M. Shah

A. Basu

K. E. Roberts

S. Sidhom

Ioana Preston


Nicholas Hill


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Conference: 2010 International PHA Conference and Scientific Sessions

Release Date: 06.24.2010

Presentation Type: Abstracts

Shah AM2, Basu A1, Roberts K2, Sidhom S2, Preston IR2, Hill NS2.
1. Caritas Carney Hospital, Dorchester, MA, USA
2. Tufts Medical Center, Boston, MA, USA

BACKGROUNDWHO Group II consists of patients with elevated left heart filling pressure and is a very common presentation of pulmonary hypertension. Yet relatively little is understood about this Group compared to the less prevalent Group I pulmonary arterial hypertension (PAH). In this study, we sought to identify differentiating characteristics between the 2 groups based on an analysis of such patients entered into a registry at Tufts Medical Center.

METHODSData was collected prospectively from consecutive patients with IPAH and SPH undergoing right heart catheterization at Tufts Medical Center for evaluation of possible PH between 2005 and 2009and who consented to be part of the PH Database. The patient population was diagnosed as Group I or II PH based on current hemodynamic definitions:  Group I had a resting mean PA pressure ≥ 25 mmHg and a pulmonary artery wedge pressure (PAWP) ≤15 mm Hg; Group II was the same except that  PAWP was >15 mm Hg. Patients were exercised during the catheterization with a goal of Borg dyspnea score of 3 (moderate dyspnea).

RESULTS:

Table 1. Demographic Characteristics

Mean ± SD

IPAH
(Group I)

SPH
(Group II) 
P value 
No (F/M) 16/10 26/9 
No (F/M) 
Age 62 ± 15 
72 ± 10 0.00067 

 

Table 2. Hemodynamic Characteristics

Test IPAH SPH P-Value
RA sat (%) 60.31 ± 9.3 64.1 ± 5.6 NS 
Baseline PA
Systolic/Diastolic
79 ± 25
33 ± 10
58 ± 22
26 ± 10
0.0016
0.0091 
Exercise PA
Systolic/Diastolic
106 ± 19
46 ± 8
66 ± 17
29 ± 8 
0.0001
0.0001 
Baseline Mean PAP 50 ± 12 
37 ± 13 
0.0001 
Exercise Mean PAP 68 ± 12 
43 ± 10 
0.0001 
PWCP 10 ± 1.5 
20 ± 5 
0.0001 
CO 5.13 ± 3 
5.21 ± 1.02 
NS 
CI 2.74 ± 1.45 
2.80± 0.46 
NS 

 

CONCLUSION: Group I IPAH patients were younger, had higher baseline as well as exercise systolic, diastolic and mean pulmonary artery pressures, and lower wedge pressures than Group II patients. Women were more numerous than men in both groups. In addition, the Group I patients were significantly older than previously reported.