[Prognostic importance of pulmonary hypertension in heart failure with preserved ejection fraction]

Pulmonary hypertension (PH) is a frequent complication in heart failure (HF). However, its impact factor in heart failure with preserved ejection fraction (HFPEF) is not well-known. This study has aimed to identify the prognostic value of PH in hospitalized patients with HFPEF.

An observational and prospective trial of patients admitted due to HFPEF (LVEF >45%). Pulmonary hypertension was defined by Pulmonary artery systolic pressure (PASP) >35mm Hg measured by the tricuspid regurgitation velocity plus atrial pressure. The primary endpoint was all-cause mortality and/or readmissions during 1-year follow-up. Kaplan-Meier survival curves and Cox regression were performed to identify adjusted hazard ratios (HR).

A total of 218 patients completed the follow-up period, 56 patients (32.2%) had PASP >35mm Hg. Primary endpoint was observed in 126 patients (57.8%) and 70 patients (32.2%) died. Kaplan-Meier survival curves showed increased significantly all-cause mortality and/or readmission in patients with PH (Log Rank <0.001) and mortality (Log Rank 0.019). Patients with PH were an increased adjusted risk for primary endpoint, HR 2.03 (CI 95%: 1.39-2.96; p<0.001) and all-cause mortality, HR 1.84 (CI 95%: 1.11-3.03; p=0.017).

Pulmonary hypertension (PASP >35mm Hg) measured by non-invasive methods is a strong and independent predictor of an unfavorable outcome in patients hospitalized due to heart failure and normal or only mildly reduced ejection fraction.