Pulmonary Arterial Capacitance Is an Important Predictor of Mortality in XXXX With a Preserved Ejection Fraction.

@entity1 @entity712 @entity120 @entity842 @entity299 @entity204
OBJECTIVES: The purpose of this study was to determine the predictors of mortality in @entity1 with @entity120 ( @entity120 ) associated with @entity712 ( @entity712 ). BACKGROUND: @entity120 is commonly associated with @entity712 . The predictors of mortality for @entity1 with these conditions are not well characterized. METHODS: In a prospective cohort of @entity1 with right heart catheterization, we identified 73  adult  @entity1 who had @entity120 due to left @entity299 ( @entity120 -LHD) associated with @entity712 (left ventricular ejection fraction  >= 50% by echocardiography); hemodynamically defined as a mean pulmonary artery pressure  >= 25  mm  Hg and pulmonary artery wedge pressure >15 mm  Hg. @entity120 severity was classified according to the diastolic pressure gradient (DPG). Cox proportional hazards ratios were used to estimate the associations between clinical variables and mortality. Receiver-operating characteristic curves were used to evaluate the ability of hemodynamic measurements to predict mortality. RESULTS: The mean age for study subjects was 69    12 years and 74% were female. @entity1 classified as having combined post-capillary @entity120 and pre-capillary @entity120 (DPG  >= 7) were not at increased risk of @entity204 as compared to @entity1 with isolated post-capillary @entity120 (DPG  <7). A baseline pulmonary arterial capacitance (PAC) of  <1.1  ml/mm  Hg was 91% sensitive in predicting mortality, with better discriminatory ability than DPG, transpulmonary gradient, or pulmonary vascular resistance (area under the curve of 0.73, 0.50, 0.45, and 0.37, respectively). Fifty-seven subjects underwent acute vasoreactivity testing with inhaled @entity842 . Acute vasodilator response by the Rich or Sitbon criteria was not associated with improved survival. CONCLUSIONS: PAC is the best predictor of mortality in our cohort and may be useful in describing phenotypic subgroups among those with @entity120 -LHD associated with @entity712 . Acute vasodilator testing did not predict outcome in our cohort but needs to be further investigated.
