Prognostic factors in pulmonary hypertension

Pulmonary hypertension is a hemodynamic and pathophysiological condition defined as an increase in mean pulmonary pressure more than or equal to 25 mm Hg. Evaluation of pulmonary hypertension severity and prognosis plays a central role in the management of these patients, between diagnosis and therapeutic decision making. The aim of our study was to identify the adverse prognostic factors in patients with pulmonary hypertension and their impact on mortality, quality of life, need for hospitalization and complications during hospitalization.

We performed a prospective study that included 553 patients diagnosed with pulmonary hypertension in the Institute of Cardiovascular Diseases of Iasi between 1st November 2008 and 1st July 2011. We analyzed a series of demographic and clinical data, echocardiographic and hemodynamic parameters, which correlated with mortality, WHO functional class, complications and need for hospitalization.

We identified as main negative prognostic factors: WHO functional class III and IV, the pulmonary artery systolic pressure value, right chambers dilation, TAPSE, pericardial effusion, cardiac index and right atrial pressure.

Pulmonary hypertension, despite the development of treatment methods, remains a serious disease, with progressive and inexorable evolution, but the prognosis of patients with pulmonary hypertension is very variable, depending on the etiology, functional class, clinical, echocardiographic and hemodynamic parameters.