Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

Fischer, Lukas; Benjamin, Nicola; Blank, Norbert; Egenlauf, Benjamin; Fischer, Christine; Harutyunova, Satenik; Koegler, Maria; Lorenz, Hanns-Martin; Marra, Alberto M.; Nagel, Christian; Xanthouli, Panagiota; Bossone, Eduardo; Grünig, Ekkehard

doi:10.1186/s12931-018-0913-x

Table 2 Comparison of patients with small and large right heart size

From: Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

				n	RA area ≤ 16 cm²			n	RA area > 16 cm²			p-value		n	RV area ≤ 20 cm²			n	RV area > 20 cm²			p-value
Demographics		Age	(years)	33	53.6	±	14.4	21	52.1	±	15.3	0.71		30	51.4	±	13.7	24	55.1	±	15.8	0.354
Demographics		BMI	(kg/m ² )	33	28.3	±	6.5	21	27.3	±	4.3	0.537		30	27.5	±	5.5	24	28.4	±	6.1	0.591
		6-MWD	(m)	32	429	±	124	21	414	±	97	0.655		30	436	±	127	23	406	±	92	0.350
PAH-targeted medication		ERA			24	(72.7%)			16	(76.2%)		1.0			22	(73.3%)			18	(75%)		1.0
		PDE5-I			22	(66.7%)			16	(76.2%)		0.549			21	(70%)			17	(70.8%)		1.0
		sGC stimulator			3	(9.1%)			5	(23.8%)		0.238			3	(10%)			5	(20.8%)		0.443
		Prostanoids			3	(9.1%)			3	(14.3%)		0.667			2	(6.7%)			4	(16.7%)		0.389
		Calcium channel blockers			2	(6.1%)			0			0.516			2	(6.7%)			0			0.497
Combination therapy		Mono	n (%)		13	(39.4%)			5	(23.8%)		0.102			11	(36.7%)			7	(29.2%)		0.414
		Double	n (%)		17	(51.5%)			14	(66.7%)					17	(56.7%)			14	(58.3%)
		Triple	n (%)		3	(9.1%)			2	(9.5%)					2	(6.6%)			3	(12.5%)
Echocardiography		RV area	(cm ² )	33	17.3	±	3.9	21	24.6	±	4.9	< 0.0001	*	30	16.3	±	3.1	24	25.0	±	4.0	< 0.0001	*
		RA area	(cm ² )	33	13.2	±	2.7	21	22.4	±	7.1	< 0.0001	*	30	13.3	±	3.2	24	21.1	±	7.2	< 0.0001	*
		sPAP	(mmHg)	33	42	±	16	21	57	±	17	0.003	*	30	42	±	12	24	56		20	0.006	*
		TAPSE	(cm)	33	2.4	±	0.4	21	2.3	±	0.4	0.362		30	2.4	±	0.4	24	2.3	±	0.4	0.204
Cardiopulmonary Exercise Testing		peak V’O₂	(ml/min)	33	1155	±	495	21	1080	±	302	0.536		30	1144	±	435	24	1103	±	429	0.730
Cardiopulmonary Exercise Testing		peak V’O₂/kg	(ml/min/kg)	33	14.5	±	4.1	21	13.4	±	3.7	0.321		30	14.7	±	3.6	24	13.2	±	4.2	0.166
Laboratory analysis		NT-proBNP	(pg/ml)	33	191	±	231	20	931	±	1266	0.018	*	30	145	±	125	23	895	±	1191	0.006	*
Pulmonary function test		DLCOc SB	(% Soll)	30	58.6	±	18.6	18	58.6	±	15.2	0.988		27	60.5	±	15.3	21	56.2	±	19.6	0.398
Pulmonary function test		DLCOc VA	(% Soll)	30	69.0	±	21.2	18	72.8	±	18.1	0.522		27	70.1	±	19.3	21	70.8	±	21.3	0.906
RHC	Rest	mPAP	(mmHg)	33	32	±	10	21	41	±	13	0.012	*	30	32	±	9	24	40	±	13	0.014	*
		sPAP	(mmHg)	33	51	±	17	21	68	±	22	0.002	*	30	51	±	16	24	66	±	24	0.013	*
		dPAP	(mmHg)	33	21	±	6	21	26	±	9	0.032	*	30	21	±	6	24	26	±	9	0.018	*
		PAWP	(mmHg)	33	10	±	3	21	10	±	4	0.514		30	10	±	3	24	10	±	4	0.852
		PVR	(dynseccm ^− 5 )	33	335	±	201	21	486	±	259	0.03	*	30	311	±	149	24	496	±	282	0.006	*
		CI	(l/min/m ² )	33	3.08	±	0.63	21	2.93	±	0.88	0.470		30	3.19	±	0.67	24	2.82	±	0.77	0.062
		HR	(1/min)	33	74	±	12	21	76	±	12	0.480		30	75	±	10	24	75	±	13	0.927
		SV	(ml)	33	79.4	±	21.2	21	77.1	±	25.4	0.716		30	80.1	±	19.0	24	76.4	±	27.0	0.556
		SVI	(ml/m ² )	33	42.2	±	8.4	21	39.3	±	12.6	0.317		30	42.9	±	8.4	24	38.8	±	11.9	0.142
	25 W	∆ CI	(l/min/m ² )	31	1.4	±	0.7	20	0.9	±	0.5	0.008	*	28	1.3	±	0.7	23	1.0	±	0.6	0.114
		HR	(1/min)	31	91	±	18	20	93	±	12	0.572		28	91	±	18	23	93	±	13	0.623
		∆ SV	(ml)	31	14.6	±	20.4	20	6.2	±	12.3	0.105		28	15.0	±	21.5	23	6.9	±	11.5	0.112
	50 W	∆ CI	(l/min/m ² )	31	2.2	±	1.0	18	1.6	±	0.7	0.027	*	28	2.28	±	0.91	21	1.51	±	0.76	0.003	*
		HR	(1/min)	31	103	±	17	18	105	±	17	0.639		28	102	±	18	21	106	±	15	0.345
		∆ SV	(ml)	31	18.0	±	22.7	18	7.2	±	13.1	0.041	*	28	21.0	±	22.5	21	4.7	±	12.0	0.002	*
	75 W	∆ CI	(l/min/m ² )	18	2.9	±	1.2	9	2.0	±	0.6	0.043	*	16	2.93	±	1.17	11	2.09	±	0.96	0.060
		HR	(1/min)	18	113	±	16	9	112	±	12	0.813		16	111	±	17	11	115	±	10	0.541
		∆ SV	(ml)	18	22.2	±	18.1	9	7.4	±	18.1	0.045	*	16	25.0	±	14.2	11	6.0	±	18.2	0.005	*
	Peak	mPAP	(mmHg)	33	54	±	15	21	61	±	17	0.115		30	54	±	15	24	60	±	17	0.124
		sPAP	(mmHg)	33	84	±	26	21	100	±	30	0.049	*	30	85	±	25	24	97	±	31	0.144
		dPAP	(mmHg)	33	35	±	12	21	38	±	11	0.254		30	34	±	12	24	39	±	10	0.111
		CI	(l/min/m ² )	33	5.62	±	1.57	21	4.80	±	1.52	0.049	*	30	5.92	±	1.43	24	4.52	±	1.45	0.001	*
		∆ CI	(l/min/m ² )	33	2.54	±	1.42	21	1.86	±	0.83	0.033	*	30	2.73	±	1.34	24	1.7	±	0.88	0.002	*
		SV	(ml)	33	93.3	±	26.7	21	86.0	±	33.8	0.383		30	0.1	±	0.027	24	0.08	±	0.029	0.007	*
		PAC	(ml/mmHg)	33	39.0	±	13.7	21	33.1	±	12.4	0.108		30	39.5	±	11.2	24	33.2	±	15.3	0.027	*
		SVI	(l/m²)	33	49.4	±	11.5	21	43.7	±	16.6	0.141		30	53.1	±	11.1	24	39.8	±	13.7	< 0.001	*

ERA = Endothelin receptor antagonist, PDE5-I = Phosphodiesterase-5-inhibitors, sGC stimulator = Soluble guanylate cyclase-stimulator, RHC = right heart catheter, BMI = Body Mass Index, RV = right ventricular, RA = right atrial, TAPSE = tricuspid annular plane systolic excursion, VO’2 = oxygen consumption, NT-proBNP = N-terminal pro brain natriuretic peptide, DLCOc SB = diffusion capacity transfer factor, DLCOc / VA = diffusion capacity transfer coefficient, mPAP = mean pulmonary arterial pressure, sPAP = systolic PAP, dPAP = diastolic PAP, PAWP = pulmonary arterial wedge pressure, PVR = pulmonary vascular resistance, CI = Cardiac Index, SVI = stroke volume index, HR = heart rate, SV = stroke volume, ∆ = difference
* = significant at level 0.05.; values are given as mean ± standard deviation or n (%)

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