Table 2. Hemodynamic and Echocardiographic Characteristics by WSPH Classification.
Abbreviations: CI=cardiac index, CO=cardiac output, Ea=effective arterial elastance, Ees= end-systolic elastance, RA=right atrium, RV=right ventricle, PA=pulmonary artery, PAH=pulmonary arterial hypertension, PCWP=pulmonary capillary wedge pressure, PH=pulmonary hypertension, SSc=systemic sclerosis, WSPH=World Symposium of Pulmonary Hypertension.
| Entire Study Cohort (n=42) | SSc no PH (n=9) | SSc PH (n=20+5 +8) | SSc-PAH (n=20) | SSc-HFpEF-PH (n=5) | SSc-ILD-PH (n=8) | p-value* | p-value# | |
|---|---|---|---|---|---|---|---|---|
| Hemodynamic Parameters | ||||||||
| Heart Rate (bpm) | 73 ± 10 | 75 ± 10 | 73 ± 10 | 74 ± 10 | 69 ± 7 | 73 ± 13 | 0.63 | 0.81 |
| Systolic Blood Pressure (mmHg) | 131 ± 20 | 144 ± 11 | 127 ± 20 | 127 ± 19 | 138 ± 24 | 123 ± 19 | 0.02 | 0.07 |
| Diastolic Blood Pressure (mmHg) | 71 ± 10 | 69 ± 8 | 71 ± 10 | 71 ± 12 | 73 ± 12 | 71 ± 7 | 0.48 | 0.90 |
| RA pressure (mmHg) | 6.3 ± 4.1 | 3.4 ± 0.9 | 6.9 ± 4.3 | 7.5 ± 4.7 | 8.6 ± 1.9 | 4.6 ± 3.5 | 0.02 | 0.02 |
| RV systolic pressure (mmHg) | 48.3 ± 21.6 | 30.7 ± 5.3 | 53.8 ± 21.8 | 61.0 ± 24.6 | 40.2 ± 7.9 | 40.6 ± 8.0 | 0.003 | 0.001 |
| RV diastolic pressure (mmHg) | 7.3 ± 4.8 | 3.7 ± 1.2 | 8.6 ± 5.4 | 9.3 ± 5.4 | 9.4 ± 3.3 | 5.3 ± 3.4 | 0.01 | 0.009 |
| PA systolic pressure (mmHg) | 48.9 ± 21.3 | 30.6 ± 6.3 | 53.9 ± 21.2 | 61.7 ± 23.8 | 41.2 ± 7.4 | 42.3 ± 7.4 | 0.003 | 0.0005 |
| PA diastolic pressure (mmHg) | 18.2 ± 8.0 | 10.2 ± 1.9 | 20.2 ± 7.9 | 22.6 ± 8.6 | 18.6 ± 4.5 | 16 ± 4.1 | 0.0006 | 0.0004 |
| Mean PA pressure (mmHg) | 29.5 ± 12.8 | 17.3 ± 3.1 | 32.8 ± 12.4 | 37.3 ± 13.6 | 27 ± 6.5 | 25.3 ± 5.8 | 0.0007 | 0.0002 |
| PCWP (mmHg) | 10.3 ± 4.1 | 9.1 ± 2.4 | 10.7 ± 4.4 | 10.2 ± 3.9 | 16.2 ± 4.3 | 8.6 ± 3.0 | 0.30 | 0.003 |
| PVR (WU) | 4.7 ± 4.2 | 1.9 ± 0.9 | 5.6 ± 4.3 | 7.0 ± 4.9 | 2.5 ± 1.8 | 3.9 ± 1.4 | 0.02 | 0.004 |
| CO (L/min) | 4.7 ± 1.3 | 4.6 ± 0.8 | 4.7 ± 1.3 | 4.6 ± 1.3 | 5.4 ± 2.4 | 4.5 ± 0.8 | 0.88 | 0.58 |
| CI (L/min/m2) | 2.6 ± 0.6 | 2.6 ± 0.3 | 2.6 ± 0.7 | 2.5 ± 0.6 | 2.7 ± 1.2 | 2.5 ± 0.5 | 0.79 | 0.96 |
| PA saturation (%) | 68.3 ± 5.2 | 70.6 ± 3.1 | 67.7 ± 5.5 | 66.6 ± 5.9 | 68.7 ± 6.1 | 70.1 ± 3.7 | 0.19 | 0.24 |
| Ea (mmHg/mL) | 0.72 ± 0.47 | 0.42 ± 0.14 | 0.82 ± 0.56 | 0.95 ± 0.56 | 0.43 ± 0.17 | 0.66 ± 0.24 | 0.03 | 0.02 |
| Ees (mmHg/mL) | 0.63 ± 0.32 | 0.81 ± 0.42 | 0.58 ± .28 | 0.57 ± 0.17 | 0.52 ± 0.12 | 0.66 ± 0.51 | 0.07 | 0.02 |
| Ees/Ea | 1.13 ± 0.83 | 2.05 ± 1.06 | 0.91 ± 0.56 | 0.78 ± 0.48 | 1.29 ± 0.42 | 1.03 ± 0.74 | 0.0001 | 0.0005 |
| Echocardiographic Parameters | ||||||||
| LV Ejection Fraction, % | 60 ± 8 | 61 ± 8 | 60 ± 8 | 61 ± 7 | 56 ± 11 | 59 ± 8 | 0.78 | 0.72 |
| Mitral E/A ratio | 1.1 ± 0.4 | 0.9 ± 0.2 | 1.2 ± 0.5 | 1.1 ± 0.3 | 1.7 ± 0.9 | 1.1 ± 0.4 | 0.12 | 0.24 |
| E/e’ (n=27) | 11.8 ± 5.3 | 10.6 ± 6.6 | 12.1 ± 5.6 | 12.4 ± 5.8 | 12.2 ± 3.6 | 11.1 ± 6.8 | 0.60 | 0.66 |
| RA Area, cm2 | 15.1 ± 4.4 | 13.1 ± 3.4 | 15.6 ± 4.6 | 15.3 ± 4.3 | 18.7 ± 6.7 | 14.1 ± 2.8 | 0.14 | 0.26 |
| RV basal diameter, cm | 3.8 ± 0.7 | 3.7 ± 0.8 | 3.8 ± 0.6 | 4.0 ± 0.7 | 3.7 ± 0.3 | 3.5 ± 0.6 | 0.49 | 0.33 |
| RVEDd, cm | 3.1 ± 0.5 | 3.0 ± 0.6 | 3.2 ± 0.4 | 3.1 ± 0.4 | 3.1 ± 0.4 | 3.2 ± 0.5 | 0.72 | 0.95 |
| RVEDA, cm2 | 20.2 ± 6.6 | 17.3 ± 6.7 | 21.0 ± 6.4 | 21.2 ± 6.6 | 22.0 ± 6.5 | 19.4 ± 6.6 | 0.10 | 0.33 |
| RVESA, cm2 | 12.4 ± 5.8 | 10.2 ± 6.4 | 12.9 ± 5.6 | 13.8 ± 6.0 | 10.9 ± 2.5 | 12.0 ± 6.2 | 0.10 | 0.30 |
| TAPSE, mm, n=32 | 17.9 ± 5.0 | 18.8 ± 6.3 | 17.6 ± 4.6 | 17.1 ± 3.9 | 21.0 ± 8.0 | 16.8 ± 3.3 | 0.18 | 0.29 |
| PASP, mmHg, n=29 | 46.0 ± 22.1 | 28.3 ± 5.6 | 50.6 ± 22.4 | 60.6 ± 25.7 | 35 ± 4.2 | 39.3 ± 3.7 | 0.0001 | 0.0009 |
| TDI S’ Velocity, cm/s, n=21 | 11.5 ± 4.0 | 10.9 ± 3.0 | 11.7 ± 4.2 | 9.7 ± 1.7 | 16.2 ± 6.0 | 11.6 ± 3.3 | .65 | .27 |
| FAC, % | 40.7 ± 11.1 | 44.3 ± 11.7 | 39.7 ± 10.8 | 36.9 ± 10.6 | 49.2 ± 7.3 | 40.5 ± 10.5 | 0.25 | 0.07 |
| Basal RVFWS, % | −22.4 ± 7.7 | −25.8 ± 6.9 | −21.6 ± 6.9 | −22.1 ± 5.9 | −23.0 ± 11.3 | −19.5 ± 6.6 | 0.06 | 0.24 |
| Midventricular RVFWS, % | −18.3 ± 6.1 | −18.7 ± 3.0 | −18.2 ± 6.6 | −18.9 ± 7.2 | −17.8 ± 4.1 | −16.7 ± 6.5 | 0.85 | 0.97 |
| Apical RVFWS, % | −12.3 ± 6.6 | −11.1 ± 6.0 | −12.5 ± 6.8 | −12.2 ± 7.6 | −13.6 ± 6.7 | −12.6 ± 5.4 | 0.67 | 0.94 |
| Global RVFWS, % | −17.7 ± 5.2 | −18.5 ± 4.3 | −17.5 ± 5.5 | −17.9 ± 5.5 | −18.2 ± 6.5 | −16.0 ± 5.2 | 0.65 | 0.79 |
| RA reservoir strain, % | 25.9 ± 8.1 | 22.7 ± 5.0 | 26.7 ± 8.7 | 26.0 ± 7.8 | 32.2 ± 9.6 | 24.8 ± 10.4 | 0.28 | 0.32 |
| RA booster strain, % | −12.7 ± 5.9 | −9.5 ± 4.9 | −13.5 ± 5.9 | −13.1 ± 5.9 | −15.8 ± 6.8 | −13.2 ± 5.9 | 0.12 | 0.37 |
| RA conduit strain, % | −13.8 ± 5.3 | −14.1 ± 5.9 | −13.6 ± 5.3 | −13.6 ± 5.1 | −16.2 ± 4.8 | −12 ± 6.2 | 0.92 | 0.68 |
| TAPSE/PASP, mm/mmHg, n=25 | 0.49 ± 0.26 | 0.75 ± 0.25 | 0.41 ± 0.20 | 0.30 ± 0.12 | 0.62 ± 0.31 | 0.42 ± 0.09 | 0.001 | 0.003 |
| FAC/PASP, %/mmHg, n=29 | 1.09 ± 0.61 | 1.79 ± 0.50 | 0.89 ± 0.48 | 0.72 ± 0.47 | 1.41 ± 0.39 | 0.94 ± 0.26 | 0.0009 | 0.0002 |
| TDI S’/PASP, cm/s/mmHg, n=17 | 0.31 ± 0.18 | 0.41 ± 0.11 | 0.29 ± 0.19 | 0.16 ± 0.09 | 0.48 ± 0.21 | 0.27 ± 0.05 | 0.10 | 0.02 |
| Global RVFWS/PASP, %/mmHg, n=29 | −0.43 ± 0.22 | −0.72 ± 0.19 | −0.39 ± 0.19 | −0.33 ± 0.20 | −0.56 ± 0.10 | −0.39 ± 0.14 | 0.01 | 0.01 |
| Basal RVFWS/PASP, %/mmHg, n=29 | −0.55 ± 0.34 | −0.85 ± 0.53 | −0.48 ± 0.24 | −0.42 ± 0.24 | −0.69 ± 0.26 | −0.48 ± 0.17 | 0.11 | 0.12 |
| RA reservoir strain/PASP, %/mmHg, n=21 | 0.69 ± 0.35 | 0.67 ± 0.36 | 0.62 ± 0.38 | 0.94 ± 0.33 | 0.51 ± 0.23 | 0.51 ± 0.23 | 0.37 | 0.28 |
| Moderate, n (%) | 1 (3) | 0 (0) | 1 (3) | 0 (0) | 0 (0) | 3 (12) | ||
*
p-value represents comparison between SSc no PH and SSc-PH
#
p-value represents SSc no PH vs. SSc-PAH vs. SSc-HFpEF-PH vs. SSc-ILD-PH
Bolded font signifies statistical significance, p-value<0.05