TABLE 3.
Summary Cardiac Characteristics of Patients With Group 1 PAH, Healthy Control Subjects, and Comparators
|
P Value |
||||||||
|---|---|---|---|---|---|---|---|---|
| PAH (n = 186) | Healthy Control (n = 78) | Comparator (n = 32) | PAH vs Comparato | All 3 Groups | ||||
|
| ||||||||
| Echocardiography | ||||||||
| Primary variable | ||||||||
| RV systolic pressure, mm Hg | 162 | 65.3 ± 22.8a,b | 60 | 24.3 ± 4.9b,c | 26 | 32.9 ± 9.6a,c | <0.001d | <0.001d |
| Secondary variables | ||||||||
| RV end-diastolic area, cm/m2 | 168 | 27.6 (22.5–36.1)a,b | 74 | 18.1 (15.0–20.1)c | 26 | 16.7 (14.3–20.8)c | <0.001e | <0.001e |
| RV end-diastolic basal dimension, cm | 177 | 4.6 ± 0.87a,b | 76 | 3.6 ± 0.49c | 28 | 3.8 ± 0.66c | <0.001d | <0.001d |
| RV diastolic wall thickness, cm | 169 | 0.61 (0.51–0.74)a,b | 71 | 0.46 (0.40–0.52)c | 28 | 0.47 (0.41–0.53)c | <0.001e | <0.001e |
| Global RV free wall peak longitudinal strain (3 segments), % | 152 | −18.4 ± 5.6a,b | 59 | −25.8 ± 6.2c | 21 | −25.1 ± 5.4c | <0.001d | <0.001d |
| Global RV free wall peak longitudinal strain (6 segments), % | 149 | −17.1 ± 4.7a,b | 59 | −23.9 ± 5.2c | 21 | −23.0 ± 4.4c | <0.001d | <0.001d |
| RV fractional shortening, % | 168 | 29.7 ± 10.0a,b | 73 | 43.4 ± 5.6c | 26 | 42.2 ± 6.8c | <0.001d | <0.001d |
| RV outflow tract velocity-time integral, cm | 174 | 14.3 (11.8–17.2)a | 74 | 15.7 (14.4–17.3)c | 29 | 16.1 (15.1–17.7) | 0.020e | 0.002e |
| Tricuspid annular plane systolic excursion, cm | 166 | 1.9 ± 0.48a,b | 74 | 2.3 ± 0.41c | 25 | 2.2 ± 0.38c | 0.001d | <0.001d |
| Tricuspid valve regurgitation degree | 181 | 76 | 29 | 0.55f | <0.001g | |||
| None or trace | 44 (24.3)a | 53 (69.7)b,c | 9 (31.0)a | |||||
| Mild | 85 (47.0) | 23 (30.3) | 14 (48.3) | |||||
| Moderate | 42 (23.2) | 0 (0.00) | 6 (20.7) | |||||
| Severe | 10 (5.5) | 0 (0.00) | 0 (0.00) | |||||
| Lateral E/e′ ratio | 173 | 7.1 (5.6–9.8)a,b | 78 | 6.3 (5.4–7.6)b,c | 29 | 9.6 (7.5–12.2)a,c | 0.007e | <0.001e |
| Left atrial volume index, mL/m2 | 159 | 23.1 (19.9–28.9)a | 77 | 20.8 (18.0–23.4)c | 29 | 23.1 (19.3–27.4) | 0.83e | 0.003e |
| Cardiac magnetic resonance imaging | ||||||||
| Primary variable | ||||||||
| RV ejection fraction, % | 139 | 37.6 ± 12.1a,b | 68 | 56.3 ± 6.1c | 23 | 54.3 ± 7.8c | <0.001d | <0.001d |
| Secondary variables | ||||||||
| RV end-diastolic volume index, mL/m2 | 139 | 100.5 (78.5–129.1)a,b | 68 | 72.6 (60.5–79.0)c | 23 | 69.3 (59.7–87.7)c | <0.001e | <0.001e |
| RV end-systolic volume index, mL/m2 | 139 | 59.4 (42.4–86.8)a,b | 68 | 31.0 (26.5–37.2)c | 23 | 33.3 (24.7–44.0)c | <0.001e | <0.001e |
| RV stroke volume index, mL/m2 | 139 | 37.6 ± 10.5 | 68 | 39.6 ± 7.9 | 23 | 40.0 ± 10.9 | 0.32d | 0.28d |
| RV mass, g | 139 | 43.4 ± 22.1a,b | 68 | 26.5 ± 10.0c | 23 | 24.4 ± 7.7c | <0.001d | <0.001d |
| RV peak global longitudinal systolic strain, % | 114 | −15.8 ± 5.1a,b | 60 | −20.4 ± 5.4c | 20 | −21.3 ± 4.9c | <0.001d | <0.001d |
| RA ejection fraction, % | 138 | 36.4 (27.9–45.9)a | 68 | 45.2 (37.0–52.1)c | 22 | 40.0 (30.8–47.8) | 0.40e | <0.001e |
| RA end-systolic volume index, mL/m2 | 138 | 39.7 (28.4–56.7)a | 68 | 26.8 (18.7–38.0)b,c | 22 | 35.1 (30.2–46.4)a | 0.22e | <0.001e |
| Left ventricular mass index, g/m2 | 140 | 41.9 (36.8–51.6) | 68 | 41.9 (37.7–49.2) | 23 | 39.4 (34.9–46.4) | 0.22e | 0.46e |
| Left ventricular end-diastolic volume index, mL/m2 | 140 | 62.4 (52.2–75.6)a | 68 | 72.3 (59.5–82.4)c | 23 | 64.7 (48.1–82.0) | 0.73e | 0.007e |
| Left ventricular end-systolic volume index, mL/m2 | 140 | 25.4 (20.7–32.1)a | 68 | 30.3 (23.5–35.2)c | 23 | 26.4 (18.9–31.4) | 0.98e | 0.013e |
| Right heart catheterization | ||||||||
| Primary variable | ||||||||
| Mean PA pressure (spontaneous breathing), mm Hg | 184 | 44.2 ± 15.3b | 0 | − | 31 | 16.6 ± 3.7c | <0.001d | |
| Secondary variables | ||||||||
| Mean RA pressure (spontaneous breathing), mm Hg | 183 | 7.9 ± 5.2b | 0 | − | 31 | 4.2 ± 2.4c | <0.001d | <0.001d |
| PCWP, mean (spontaneous breathing), mm Hg | 183 | 11.3 ± 5.5b | 0 | − | 31 | 7.8 ± 3.1c | <0.001d | <0.001d |
| Pulmonary vascular resistance (spontaneous breathing), WU | 180 | 7.1 ± 3.9b | 0 | − | 31 | 1.6 ± 0.75c | <0.001d | <0.001d |
| Cardiac output | 182 | 5.2 ± 1.6b | 0 | − | 31 | 6.1 ± 1.9c | 0.007d | 0.007d |
| Cardiac index, L/min/m2 | 182 | 2.7 ± 0.76b | 0 | − | 31 | 3.1 ± 0.91c | 0.004d | 0.004d |
| Electrocardiography | ||||||||
| Primary variable | ||||||||
| RV hypertrophy presence | 185 | 33 (17.8)a | 74 | 0 (0.00)c | 31 | 1 (3.2) | 0.035g | <0.001f |
| Secondary variables | ||||||||
| Right bundle branch block | 185 | 21 (11.4)a | 74 | 1 (1.4)c | 31 | 3 (9.7) | 0.99g | 0.034f |
| Right-axis deviation | 185 | 83 (44.9)a,b | 75 | 1 (1.3)c | 31 | 0 (0.00)c | <0.001f | <0.001f |
| RA enlargement | 185 | 21 (11.4)a | 74 | 0 (0.00)c | 31 | 0 (0.00) | 0.050f | 0.002f |
Values are n, mean ± SD, median (Q1-Q3), or n (column %). Post hoc pairwise comparisons were performed using Bonferroni adjustment.
a
Significantly different from healthy control group.
b
Significantly different from comparator group.
c
Significantly different from PAH group.
d
Analysis of variance.
e
Kruskal-Wallis test.
f
Pearson chi-square test.
g
Fisher exact test.
PA = pulmonary artery; PAH = pulmonary arterial hypertension; PCWP = pulmonary capillary wedge pressure; RA = right atrial; RV = right ventricular.