Photo Credit: Hank Grebe

The following is a summary of “Frequency, characteristics and risk assessment of pulmonary arterial hypertension with a left heart disease phenotype,” published in the April 2024 issue of Cardiology by Toma et al.

Researchers conducted a retrospective study collecting and evaluating features and risk stratification of pulmonary arterial hypertension (PAH) with left heart disease (LHD) phenotype (PAH-LHD). 

They used records of 286 patients with PAH from 2001 to 2021 from seven centers. All risk of death parameters were assessed using COMPERA and COMPERA 2.0 scores at baseline and first follow-up.

The results showed that 57 (20%) had PAH-LHD condition according to the AMBITION definition. These patients were older with higher BMI, more cardiovascular issues, and different heart measurements (higher E/e’ ratio and left atrial area, lower BNP concentrations, and better RV function and pulmonary hemodynamics) compared to patients with non-LHD. Survival rates were similar, but patients with PAH-LHD were less likely to get dual PAH therapy. COMPERA and COMPERA 2.0 scores predicted mortality risk for patients with PAH-LHD during follow-up, with COMPERA 2.0 improving over time. In multivariable analysis, high-risk scores were linked to higher mortality risk, but the LHD phenotype wasn’t. These findings were consistent even when we considered patients from the last decade and included atrial fibrillation and echocardiographic abnormalities as extra criteria for PAH-LHD.

Investigators concluded that PAH-LHD patients are frequent, have less severe disease and are less likely treated with PAH drug combinations than no-LHD. The COMPERA 2.0 could better predict their mortality risk during follow-up and show how treatment affects it.

Source: link.springer.com/article/10.1007/s00392-024-02448-9