Left heart disease (LHD) may be associated with pulmonary hypertension determined by echocardiography, according to a study published in The American Journal of Cardiology.

In this retrospective study, the data of 310 patients ≥ 90 years of age (median age 92 years, 64% women) diagnosed with echocardiographic PH with normal left ventricular systolic function were reviewed using the transthoracic echocardiography database.

Echocardiography was used to determine the type of LHD: left-sided valve disease, left ventricular diastolic dysfunction, or left ventricular hypertrophy. The study’s primary outcome was all-cause death 2000 days after diagnosis.

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In this cohort, 92% of patients had LHD. All-cause deaths occurred in 49% of the patients during the median follow up of 367 days (interquartile range, 39-1028 days). The following factors were found to be associated with mortality in a multivariable Cox regression analysis after adjusting for age: pericardial effusion (adjusted hazard ratio [aHR, 2.28;  P<.001), right ventricular fraction area change < 35% (aHR, 2.31; P <.001), chronic obstructive pulmonary disease (aHR, 1.93; P =.001), serum albumin < 3.5 g/dL (aHR, 1.76; P =.001), and New York Heart Association class ≥ II (aHR, 1.73; P =.004).

Limitations of the study include its retrospective nature and the lack of evaluation of the relationship between the severity of comorbidities and PH and prognosis.

“[E]chocardiographic PH in patients ≥ 90 years of age was significantly associated with LHD,” concluded the study authors.


Shimada S, Uno G, Omori T, Radar F, Siegel RJ, Shiota T. Characteristics and prognostic associations of echocardiographic pulmonary hypertension with normal left ventricular systolic function in patients ≥90 years of age (published online May 26, 2020). Am J Cardiol. doi.org/10.1016/j.amjcard.2020.05.031