Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry
Background: Pulmonary arterial hypertension (PAH) is a complication of left-to-right intracardiac shunt congenital heart disease (LtR-shunt CHD). There are several known predictors of mortality in PAH patients, however predictors of mortality in LtR-shunt CHD-associated PAH need to be validated....
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| Language: | English |
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Indonesian Heart Association
2025-01-01
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| Series: | Majalah Kardiologi Indonesia |
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| Online Access: | https://ijconline.id/index.php/ijc/article/view/1623 |
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| author | Muflihatul Baroroh Rochmat Budi Yuli Setianto Dyah Wulan Anggrahini Lucia Kris Dinarti Anggoro Budi Hartopo |
| author_facet | Muflihatul Baroroh Rochmat Budi Yuli Setianto Dyah Wulan Anggrahini Lucia Kris Dinarti Anggoro Budi Hartopo |
| author_sort | Muflihatul Baroroh Rochmat |
| collection | DOAJ |
| description |
Background: Pulmonary arterial hypertension (PAH) is a complication of left-to-right intracardiac shunt congenital heart disease (LtR-shunt CHD). There are several known predictors of mortality in PAH patients, however predictors of mortality in LtR-shunt CHD-associated PAH need to be validated.
Objectives: We aimed to investigate the predictors of mortality among adult LtR-shunt CHD-associated PAH patients.
Methods: This research was a retrospective cohort study that included adult patients with LtR-shunt CHD-associated PAH retrieved from the COHARD-PH registry. Several baseline variables were selected as potential predictors of mortality, namely (1) clinical data: WHO-functional class, SaO2, 6-min walking distance, systolic blood pressure, and Eisenmenger syndrome; (2) laboratory data: hemoglobin and NT-pro BNP levels; (3) echocardiography data: pericardial effusion, defect size, and TAPSE; and (4) hemodynamic data: right atrial pressure, cardiac output and index, SvO2, and flow ratio. The mortality outcome was assessed from the cohort registry.
Results: A total of 124 subjects with LtR-shunt CHD-associated PAH were included. Sixteen subjects (12.9%) died during the follow-up period. The baseline variables which showed significant association with mortality were lower systolic blood pressure, Eisenmenger syndrome, higher NT-pro BNP level, and lower cardiac output. The multivariable analysis showed that systolic blood pressure <100 mmHg (OR 10.99; 95% CI 2.54-47.51, p=0.001), cardiac index <2.5 L/min/m2 (OR 8.13; 95% CI: 1.59-42.28, p=0.011) and Eisenmenger syndrome (OR 3.87; 95%CI: 1.06-14.07) were the independent predictors for mortality.
Conclusions: The systolic blood pressure <100 mmHg, cardiac index <2.5 L/min/m2, and Eisenmenger syndrome were independent predictors of mortality among adults with LtR-shunt CHD-associated PAH.
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| format | Article |
| id | doaj-art-7add81047cf74ec4bdab1a7d571d59b0 |
| institution | Kabale University |
| issn | 0126-3773 2620-4762 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Indonesian Heart Association |
| record_format | Article |
| series | Majalah Kardiologi Indonesia |
| spelling | doaj-art-7add81047cf74ec4bdab1a7d571d59b02025-01-10T16:38:16ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622025-01-0146110.30701/ijc.1623Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registryMuflihatul Baroroh RochmatBudi Yuli SetiantoDyah Wulan AnggrahiniLucia Kris DinartiAnggoro Budi Hartopo Background: Pulmonary arterial hypertension (PAH) is a complication of left-to-right intracardiac shunt congenital heart disease (LtR-shunt CHD). There are several known predictors of mortality in PAH patients, however predictors of mortality in LtR-shunt CHD-associated PAH need to be validated. Objectives: We aimed to investigate the predictors of mortality among adult LtR-shunt CHD-associated PAH patients. Methods: This research was a retrospective cohort study that included adult patients with LtR-shunt CHD-associated PAH retrieved from the COHARD-PH registry. Several baseline variables were selected as potential predictors of mortality, namely (1) clinical data: WHO-functional class, SaO2, 6-min walking distance, systolic blood pressure, and Eisenmenger syndrome; (2) laboratory data: hemoglobin and NT-pro BNP levels; (3) echocardiography data: pericardial effusion, defect size, and TAPSE; and (4) hemodynamic data: right atrial pressure, cardiac output and index, SvO2, and flow ratio. The mortality outcome was assessed from the cohort registry. Results: A total of 124 subjects with LtR-shunt CHD-associated PAH were included. Sixteen subjects (12.9%) died during the follow-up period. The baseline variables which showed significant association with mortality were lower systolic blood pressure, Eisenmenger syndrome, higher NT-pro BNP level, and lower cardiac output. The multivariable analysis showed that systolic blood pressure <100 mmHg (OR 10.99; 95% CI 2.54-47.51, p=0.001), cardiac index <2.5 L/min/m2 (OR 8.13; 95% CI: 1.59-42.28, p=0.011) and Eisenmenger syndrome (OR 3.87; 95%CI: 1.06-14.07) were the independent predictors for mortality. Conclusions: The systolic blood pressure <100 mmHg, cardiac index <2.5 L/min/m2, and Eisenmenger syndrome were independent predictors of mortality among adults with LtR-shunt CHD-associated PAH. https://ijconline.id/index.php/ijc/article/view/1623congenital heart defectspulmonary hypertensionmortalityEisenmenger syndrome |
| spellingShingle | Muflihatul Baroroh Rochmat Budi Yuli Setianto Dyah Wulan Anggrahini Lucia Kris Dinarti Anggoro Budi Hartopo Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry Majalah Kardiologi Indonesia congenital heart defects pulmonary hypertension mortality Eisenmenger syndrome |
| title | Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry |
| title_full | Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry |
| title_fullStr | Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry |
| title_full_unstemmed | Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry |
| title_short | Systolic Blood Pressure, Cardiac Index and Eisenmenger Syndrome are Predictors of Mortality in Pulmonary Arterial Hypertension-associated with Congenital Heart Disease: An Analysis from the COHARD-PH registry |
| title_sort | systolic blood pressure cardiac index and eisenmenger syndrome are predictors of mortality in pulmonary arterial hypertension associated with congenital heart disease an analysis from the cohard ph registry |
| topic | congenital heart defects pulmonary hypertension mortality Eisenmenger syndrome |
| url | https://ijconline.id/index.php/ijc/article/view/1623 |
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