Clinical and hemodynamic profiles of elderly patients with pulmonary arterial hypertension: a single center, prospective study

ÖZPELİT E., AKDENİZ B., SEZGİN D., SEVİNÇ C., TERTEMİZ K. C., Ozpelit M. E., ...Daha Fazla

JOURNAL OF GERIATRIC CARDIOLOGY, cilt.14, sa.1, ss.20-27, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 1
  • Basım Tarihi: 2017
  • Doi Numarası: 10.11909/j.issn.1671-5411.2017.01.003
  • Dergi Adı: JOURNAL OF GERIATRIC CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.20-27
  • Anahtar Kelimeler: Clinical characteristics, Prognosis, Pulmonary hypertension, The elderly, SERUM URIC-ACID, HEART-FAILURE, SURVIVAL, VALIDATION, GUIDELINES, DIAGNOSIS, PRESSURE, EXERCISE, DISEASE
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Backgrounds Pulmonary arterial hypertension (PAH) was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. Methods In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger (18-65 years) and elderly (>= 65 years) patients with definitive diagnosis of precapillary PAH were compared. Results A total of 119 patients were analyzed in this study; 43 were elderly (mean age: 71.5 +/- 5.5 years), while 76 were non-elderly (mean age 44.5 +/- 15.2 years). During the mean follow-up duration of 26.8 +/- 25.0 months, 43 deaths occurred, 17 of which were among the elderly group, with 28 among non-elderly group. Comparison of baseline parameters showed that 6 min walking distance, hemoglobin levels, pulmonary artery pressures and pulmonary vascular resistance were significantly lower; and estimated glomerular filtration rate, body mass index, E/e' and pulmonary capillary wedge pressure were significantly higher in the elderly group than in the younger group. Survival analysis demonstrated that the independent predictors of death were tricuspid plane annular systolic excursion (TAPSE; HR: 1.272, 95% CI: 1.079-1.499, P = 0.004) and uric acid (HR: 1.291, 95% CI: 1.042-1.600, P = 0.019) in the elderly group. In contrast, in the non-elderly group, higher brain natriuretic peptide (HR: 1.002, 95% CI: 1.001-1.004, P < 0.001) and higher right atrial pressure (HR: 1.128, 95% CI: 1.026-1.241, P = 0.013) values were the only parameters associated with mortality. Conclusions Our data suggest that elderly PAH patients have a unique clinical and hemodynamic profile, with totally different prognostic markers compared to younger PAH patients.