Pulmonary-Systemic Pulse Pressure Ratio Linked to PH Mortality

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Each 1-unit increase in pulmonary-systemic pulse pressure ratio was associated with a >2-fold increase in mortality.
Each 1-unit increase in pulmonary-systemic pulse pressure ratio was associated with a >2-fold increase in mortality.

Patients with group 1 pulmonary hypertension (PH) who had a higher pulmonary-systemic pulse pressure ratio had a higher risk for mortality, according to the results of a recent study published in Heart, Lung, and Circulation.

Pulmonary-systemic pulse pressure ratios from patients with PH were obtained from medical records in the National Institute of Health Primary Pulmonary Hypertension Registry. The association between the pulmonary-systemic pulse pressure ratio and mortality was compared after adjustment after the PH connection risk equation.

Among the 262 patients participating in the study, the mean pulmonary-systemic pulse pressure ratio was 1.04. Each 1-unit increase in pulmonary-systemic pulse pressure ratio was associated with a >2-fold increase in mortality (hazard ratio, 2.06; 95% CI, 1.40-3.02; P =.0002). When pulmonary-systemic pulse pressure ratios were split into quartiles, the highest-quartile patients (a pulmonary-systemic pulse pressure ratio >1.30) had a 68% increase in mortality (adjusted hazard ratio, 1.68; 95% CI, 1.13-2.50; P =.01).

The study authors wrote, "[W]e found that [pulmonary-systemic pulse pressure ratio] was a strong and independent predictor of short-term and long-term mortality even after adjustment for the contemporary [PH connection] risk model and other significant covariates."

They added, "This highlights the critical role of [right ventricle-left ventricle] coupling in these patients and the utility of the [pulmonary-systemic pulse pressure ratio] as a parameter to characterise [right ventricle-left ventricle] coupling."

Reference

Ruth B, Bilchick K, Mysore M, et al. Increased pulmonary-systemic pulse pressure ratio is associated with increased mortality in group 1 pulmonary hypertension [published online June 14, 2018]Heart Lung Circ. doi:10.1016/j.hlc.2018.05.199

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