Correlation between pulmonary vascular performance and hemodynamics in patients with pulmonary arterial hypertension

ABSTRACT

Objective

To explore the correlation between pulmonary vascular performance and hemodynamics in patients with pulmonary arterial hypertension (PAH), using right heart catheterization (RHC) and intravascular ultrasound (IVUS).

Method

A total of 60 patients underwent RHC and IVUS examinations. Of these, 27 patients were diagnosed with PAH associated with connective tissue diseases (PAH-CTD group), 18 patients were diagnosed with other types of PAH (other-types-PAH group), and 15 patients were without PAH (control group). The hemodynamics and morphological parameters of pulmonary vessels in PAH patients were assessed using RHC and IVUS.

Results

There were statistically significant differences in right atrial pressure (RAP), pulmonary artery systolic pressure (sPAP), pulmonary artery diastolic pressure (dPAP), mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) values between the PAH-CTD group, other-types-PAH group, and the control group (P < .05). No statistically significant difference was noticed in pulmonary artery wedge pressure (PAWP) and cardiac output (CO) values between these three groups (P > .05). The mean wall thickness (MWT), wall thickness percentage (WTP), pulmonary vascular compliance, dilation, elasticity modulus, stiffness index β, and other indicators were significantly different between these three groups (P < .05). Pairwise comparison showed that the average levels of pulmonary vascular compliance and dilation in PAH-CTD group and other-types-PAH group were lower than those in control group, while the average levels of elastic modulus and stiffness index β were higher than those in control group.

Conclusion

Pulmonary vascular performance deteriorates in PAH patients, and the performance is better in PAH-CTD patients than in other types of PAH.

KEYWORDS:

• Intravascular ultrasound
• pulmonary hypertension
• pulmonary vascular morphological changes
• pulmonary vascular performance change

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval and consent to participate

This study was conducted with approval from the Ethics Committee of People’s Hospital of Xinjiang Uygur Autonomous Region (No. KY2019051567). This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants.

Availability of data and materials

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Additional information

Funding

Natural Science Foundation of Xinjiang Autonomous Region (No.2019D01C155).