The following is a summary of “Omics and Extreme Phenotyping Reveal Longitudinal Association Between Left Atrial Size and Pulmonary Vascular Resistance in Group 2 Pulmonary Hypertension,” published in the November 2023 issue of Cardiology by Kelly et al.
Pulmonary hypertension (PH) stemming from left heart disease presents diverse phenotypes, particularly variations in pulmonary vascular resistance elevation. This study aimed to distinguish between isolated postcapillary PH (IpcPH) and combined pre‐ and postcapillary PH (CpcPH) using unbiased methods. The research identified extreme cases of IpcPH and CpcPH among patients who underwent single-center right heart catheterization. Exclusion criteria involved a left ventricular ejection fraction <40% or other potential causes of PH beyond left heart disease. Comparative analysis of medication usage revealed vitamin K antagonists, notably prescribed more frequently in CpcPH, primarily for atrial fibrillation indications.
Consequently, CpcPH cases displayed a notably higher prevalence of atrial fibrillation. Echocardiographic evaluations demonstrated an augmented left atrial diameter indexed to body surface area in CpcPH, irrespective of the presence of atrial fibrillation. Moreover, a longitudinal correlation emerged between changes in left atrial diameter indexed to body surface area and alterations in pulmonary vascular resistance among an independent cohort with PH attributed to left heart disease. These findings illuminate a significant association between left atrial diameter and pulmonary vascular resistance, promising advancements in diagnostic and therapeutic approaches for PH secondary to left heart disease.
Source: ahajournals.org/doi/10.1161/JAHA.123.031746
