alexa Diastolic Pulmonary Arterial Pressure as a Prognostic Indicator for Closure of Atrial Septal Defect with Severe Pulmonary Arterial Hypertension | OMICS International | Abstract
ISSN: 2167-1095

Journal of Hypertension: Open Access
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Research Article

Diastolic Pulmonary Arterial Pressure as a Prognostic Indicator for Closure of Atrial Septal Defect with Severe Pulmonary Arterial Hypertension

Yan Chaowu1*, Pan Xiangbin1, Xu Zhongying1, Zhang Gejun1, Zheng Hong1, Jin Jinglin1, Li Shiguo1, Lv Jianhua1, Hu Haibo1, Song Huijun1, Liu Qiong1, Wan Junyi1, Xu Liang1, Zhu Zhenhui2, Pang Kunjing2 and Wang Yang3

1Department of Interventional Radiology, National Center for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

2Department of Echocardiography, National Center for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

3Department of Epidemiology, National Center for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

*Corresponding Author:
Yan Chaowu
Department of Interventional Radiology
Fuwai Hospital, 167 Beilishi Road
Beijing 100037 China
Tel: +8610-88398408
Fax: +8610-68313012
E-mail: [email protected]

Received Date: November 24, 2015; Accepted Date: September 06, 2016; Published Date: September 13, 2016

Citation: Chaowu Y, Xiangbin P, Zhongying X, Gejun Z, Hong Z, et al. (2016) Diastolic Pulmonary Arterial Pressure as a Prognostic Indicator for Closure of Atrial Septal Defect with Severe Pulmonary Arterial Hypertension . J Hypertens 5:231. doi:10.4172/2167-1095.1000231

Copyright: © 2016 Chaowu Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: In patients with atrial septal defect (ASD) and severe pulmonary arterial hypertension (PAH), diastolic pulmonary arterial pressure (DPAP) correlates closely with pulmonary vascular resistance (PVR) and can reflect the severity of pulmonary vascular disease. However, it is unclear whether DPAP has potential to become a prognostic indicator for closure of ASD with severe PAH. Objectives: This study was performed to investigate the prognostic implication of DPAP in patients with ASD and severe PAH. Methods: Among 232 patients with ASD and severe PAH (systolic pulmonary arterial pressure (SPAP)≥70 mm Hg measured with right heart catheterization), 85 patients (21M/64F) undergoing closure of ASD were followed up. Doppler-calculated SPAP was recorded to identify the normalized post-operative PAP (SPAP<40 mm Hg). According to the cut-off value of DPAP from a ROC curve, two subsets were classified: low-DPAP (<25 mm Hg, n=31) and high-DPAP (≥25 mm Hg, n=54). Results: After closure of ASD, normalization of PAP occurred in 71% of patients with low-DPAP and 7.4% of patients with high-DPAP (P<0.001). Upon adjustment for PVR and SPAP/systolic aortic pressure, the hazard ratio of post-operative persistent PAH for high-DPAP was 4.48 (95%CI: 2.04-9.81, P<0.001). The follow-up (3.6 ± 1.3 years) demonstrated that normalized post-operative PAP tended to occur in patients with low-DPAP (Log Rank, P<0.001). Conclusions: In patients with ASD and severe PAH, low-DPAP has the potential to become a predictor for the normalized post-operative PAP.

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