Related Experiment Video

Updated: May 14, 2026

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
08:08

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets

Published on: May 11, 2015

Pulsatile haemodynamic parameters are predictors of survival in paediatric pulmonary arterial hypertension

Johannes M Douwes1, Marcus T R Roofthooft, Beatrijs Bartelds

  • 1Centre for Congenital Heart Diseases, Department of Paediatric Cardiology, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, The Netherlands.

International Journal of Cardiology
|January 24, 2013
PubMed

Insights

Pulsatile parameters like pulmonary arterial compliance (PACi) and pulmonary stroke volume (PSVi) predict survival in pediatric pulmonary arterial hypertension (PAH). These, along with static measures, aid in assessing severity and guiding treatment for better outcomes.

Area of Science:

  • Cardiology
  • Pediatric Pulmonology
  • Hemodynamics

Background:

  • Pulmonary arterial hypertension (PAH) requires reliable prognostic markers, particularly in pediatric cases.
  • Pulsatile hemodynamic parameters, such as pulmonary arterial compliance (PACi) and pulmonary stroke volume (PSVi), may offer prognostic insights beyond static measures.
  • Assessing the prognostic value of PACi and PSVi in pediatric PAH is crucial for improving patient management.

Purpose of the Study:

  • To evaluate the prognostic significance of PACi and PSVi in children diagnosed with idiopathic/hereditary PAH or PAH associated with congenital heart disease.
  • To determine if pulsatile hemodynamic parameters can predict transplant-free survival in pediatric PAH patients.

Main Methods:

  • Retrospective review of right heart catheterization data from 52 pediatric PAH patients (1993-2010).
  • Comparison with a control group of patients with normal pulmonary vascular resistance.
  • Calculation of PACi and PSVi to assess their predictive value for transplant-free survival.

Main Results:

  • Pediatric PAH patients exhibited significantly lower PSVi and PACi compared to controls.
  • Lower PSVi and PACi correlated with higher WHO-functional class.
  • Higher PSVi, PACi, and mean systemic arterial pressure (mSAP), along with lower heart rate, were associated with improved survival, independent of functional class and therapy.
  • Multivariate analysis identified PSVi, heart rate, and mSAP as key hemodynamic predictors of survival.

Conclusions:

  • Both pulsatile and static hemodynamic parameters are robust, independent predictors of transplant-free survival in pediatric PAH.
  • These parameters are valuable for assessing disease severity, predicting prognosis, and guiding treatment decisions in pediatric PAH.
Abstract

Keywords:
6-MWD6-minute walk distanceCICardiac catheterizationHRHaemodynamicsIPAH/HPAHNOO2PAC(i)PAHPAH-CHDPPPSV(i)PVR(i)PaediatricsPulmonary hypertensionQpiRVSurvival analysisVO(2)WHO-classWorld Health Organization functional classcardiac indexhazard ratioidiopathic or hereditary pulmonary arterial hypertensionmPAPmRAPmSAPmean pulmonary arterial pressuremean right atrial pressuremean systemic arterial pressurenitric oxideoxygenoxygen consumptionpulmonary arterial compliance (index)pulmonary arterial hypertensionpulmonary arterial hypertension associated with congenital heart diseasepulmonary flow indexpulmonary stroke volume (index)pulmonary vascular resistance (index)pulse pressureright ventricle

More Related Videos

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography09:31

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

Published on: January 27, 2023

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS08:12

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS

Published on: November 26, 2018

Related Concept Videos

Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
Pulse01:16

Pulse

When the heart pumps blood out, arterial elastic fibers play a crucial role in sustaining a high-pressure gradient. They expand to accommodate the received blood and then recoil - a process known as the pulse that can be either manually palpated or electronically quantified. Despite a reduction in its effect with increased distance from the heart, elements of the pulse's systolic and diastolic components persist, observable even at the arteriole level.
The pulse serves as a clinical indicator...
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
Measurement of Blood Pressure01:17

Measurement of Blood Pressure

Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...