PMID- 32624190
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 129
DP  - 2020 Aug 15
TI  - Characteristics and Prognostic Associations of Echocardiographic Pulmonary 
      Hypertension With Normal Left Ventricular Systolic Function in Patients >/=90 Years 
      of Age.
PG  - 95-101
LID - S0002-9149(20)30541-5 [pii]
LID - 10.1016/j.amjcard.2020.05.031 [doi]
AB  - The high prevalence of pulmonary hypertension (PH) in elderly patients is well 
      known. However, much remains unknown about those population. We sought to find 
      the clinical characteristics of echocardiographic PH and the prognostic factors 
      in patients >/=90 years of age. We retrospectively reviewed 310 patients >/=90 years 
      of age (median age 92 years, 64% women) diagnosed as echocardiographic PH (peak 
      systolic pulmonary arterial pressure >/=40 mm Hg) with normal left ventricular 
      systolic function. We defined left heart disease (LHD) as significant left-sided 
      valve diseases, left ventricular hypertrophy and left ventricular diastolic 
      dysfunction by using echocardiography. The endpoint was all-cause death at 2,000 
      days after diagnosis. LHD was found in 92% of patients. During the median 
      follow-up of 367 days (interquartile range, 39-1,028 days), 151 all-cause deaths 
      (49%) occurred. Multivariable Cox regression analysis demonstrated that right 
      ventricular fraction area change <35% (adjusted hazard ratio [HR]: 2.31; p 
      <0.001), pericardial effusion (adjusted HR: 2.28; p <0.001), serum albumin <3.5 
      g/dL (adjusted HR: 1.76; p = 0.001), chronic obstructive pulmonary disease 
      (adjusted HR: 1.93; p = 0.001) and New York Heart Association (NYHA) class >/=II 
      (adjusted HR: 1.73; p = 0.004) were associated with mortality after adjusted for 
      age. In conclusion, LHD was significantly associated with echocardiographic PH in 
      most patients >/=90 years of age. Also, the co-morbid factors at diagnosis (right 
      ventricular systolic dysfunction, pericardial effusion, hypoalbuminemia, chronic 
      obstructive pulmonary disease, and NYHA class >/=II) were independently associated 
      with mortality.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Shimada, Shunsuke
AU  - Shimada S
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente 
      Boulevard A 3411, Los Angeles, California, 90048.
FAU - Uno, Goki
AU  - Uno G
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente 
      Boulevard A 3411, Los Angeles, California, 90048.
FAU - Omori, Taku
AU  - Omori T
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente 
      Boulevard A 3411, Los Angeles, California, 90048.
FAU - Rader, Florian
AU  - Rader F
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente 
      Boulevard A 3411, Los Angeles, California, 90048.
FAU - Siegel, Robert James
AU  - Siegel RJ
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente 
      Boulevard A 3411, Los Angeles, California, 90048.
FAU - Shiota, Takahiro
AU  - Shiota T
AD  - Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South San Vicente 
      Boulevard A 3411, Los Angeles, California, 90048. Electronic address: 
      ShiotaT@cshs.org.
LA  - eng
PT  - Journal Article
DEP - 20200526
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Serum Albumin)
SB  - IM
MH  - Aged, 80 and over
MH  - Aortic Valve Insufficiency/diagnostic imaging/epidemiology
MH  - Aortic Valve Stenosis/diagnostic imaging/epidemiology
MH  - Comorbidity
MH  - Diastole
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/diagnostic imaging/*epidemiology
MH  - Hypertrophy, Left Ventricular/diagnostic imaging/*epidemiology
MH  - Hypoalbuminemia/epidemiology
MH  - Male
MH  - Mitral Valve Insufficiency/diagnostic imaging/epidemiology
MH  - Mitral Valve Stenosis/diagnostic imaging/epidemiology
MH  - *Mortality
MH  - Multivariate Analysis
MH  - Pericardial Effusion/diagnostic imaging/epidemiology
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Pulmonary Disease, Chronic Obstructive/epidemiology
MH  - Serum Albumin
MH  - Tricuspid Valve Insufficiency/diagnostic imaging/epidemiology
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*epidemiology
MH  - Ventricular Dysfunction, Right/diagnostic imaging/epidemiology
MH  - *Ventricular Function, Left
EDAT- 2020/07/07 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/07/07 06:00
PHST- 2020/03/09 00:00 [received]
PHST- 2020/05/07 00:00 [revised]
PHST- 2020/05/15 00:00 [accepted]
PHST- 2020/07/07 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/07/07 06:00 [entrez]
AID - S0002-9149(20)30541-5 [pii]
AID - 10.1016/j.amjcard.2020.05.031 [doi]
PST - ppublish
SO  - Am J Cardiol. 2020 Aug 15;129:95-101. doi: 10.1016/j.amjcard.2020.05.031. Epub 
      2020 May 26.