Pulse Wave Analysis Predicts Invasive Hemodynamics in Pre-Capillary Pulmonary Hypertension

Area of Science:

• Cardiology
• Pulmonary Medicine
• Biomedical Engineering

Background:

• Precapillary pulmonary hypertension (PH) necessitates accurate assessment of hemodynamics and right heart function.
• Current invasive methods for hemodynamic assessment carry risks.
• Non-invasive methods like pulse wave analysis (PWA) offer a potential alternative for evaluating PH parameters.

Purpose of the Study:

• To investigate if non-invasive PWA-derived systemic circulation variables can predict invasive hemodynamics and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in precapillary PH patients.
• To identify novel non-invasive biomarkers for right heart function in PH.

Main Methods:

• Prospective study of patients with group 1 and 4 PH with complete PWA, NT-proBNP, and hemodynamics data.
• Utilized hierarchical multiple linear regression (HMLR) and receiver operating characteristic (ROC) curves.
• Principal component analysis grouped PWA variables, and a hemodynamic score (HS) was used for risk assessment.

Main Results:

• Left ventricular ejection time (LVET), a PWA parameter, was significantly and independently associated with both HS and NT-proBNP levels.
• LVET showed a significant negative correlation with HS and NT-proBNP.
• ROC analysis indicated LVET could predict low-risk HS and low-to-intermediate NT-proBNP levels with high sensitivity and specificity.

Conclusions:

• Non-invasive PWA parameter LVET independently predicts invasive right heart hemodynamic score and NT-proBNP levels.
• LVET may serve as a novel, non-invasive biomarker for right ventricular function in precapillary PH.
• This finding supports the use of PWA for risk stratification and monitoring in PH patients.