Table 1.
Baseline characteristics of patient referred to the PH clinic.
| All patients seen in PH clinic (n = 125) | Patients with confirmed PH by RHC (n = 73) | Patients without PH by RHC (n = 21) | Patients who did not undergo RHC (n = 30) or had technically limited RHC (n = 1) (n = 31 total) | |
|---|---|---|---|---|
| Age (years) | 73.6 (9.8) | 72.8 (9.0) | 73 (11.3) | 75.7 (10.5) |
| Male sex | 118/125 (94.4%) | 68/73 (93.2%) | 21/21 (100%) | 29/31 (93.6%) |
| BMI (kg/m2) | 32.8 (8.1) | 34.3 (8.3) | 29.3 (5.6) | 31.4 (8.5) |
| BMI categories | ||||
| AHA ideal health (BMI < 25) | 21/125 (16.8%) | 10/73 (13.7%) | 3/21 (14.3%) | 8/31 (25.8%) |
| AHA intermediate health (BMI ≥ 25, < 30) | 33/125 (26.4%) | 18/73 (24.7%) | 8/21 (38.1%) | 7/31 (22.6%) |
| AHA poor health (BMI ≥ 30) | 71/125 (56.8%) | 45/73 (61.6%) | 10/21 (47.6%) | 16/31 (51.6%) |
| Systemic hemodynamics | ||||
| Heart rate (bpm) | 75 (14) | 76 (14) | 76 (9) | 74 (18) |
| Systolic blood pressure (mmHg) | 125 (19) | 126 (18) | 113 (13) | 130 (19) |
| Diastolic blood pressure (mmHg) | 71 (9) | 71 (9) | 69 (8) | 70 (10) |
| Pulse pressure (mmHg) | 54 (16) | 55 (15) | 44 (11) | 60 (19) |
| Oxyhemoglobin saturation (%) | 95 (4) | 94 (4) (n = 70) | 96 (2) | 95 (4) |
| Signs and symptoms | ||||
| mMRC dyspnea score, initial visit | 3 (2, 3)* (n = 122) | 3 (2, 3)* (n = 72) | 2 (1.5, 3)* (n = 20) | 2 (1, 3)* (n = 30) |
| mMRC dyspnea score 0 | 9/122 (7.4%) | 2/72 (2.8%) | 2/20 (10.0%) | 5/30 (16.7%) |
| mMRC dyspnea score 1 | 13/122 (10.7%) | 6/72 (8.3%) | 3/20 (15.0%) | 4/30 (13.3%) |
| mMRC dyspnea score 2 | 30/122 (24.6%) | 17/72 (23.6%) | 6/20 (30.0%) | 7/30 (23.3%) |
| mMRC dyspnea score 3 | 50/122 (41.0%) | 32/72 (44.4%) | 8/20 (40.0%) | 10/30 (33.3%) |
| mMRC dyspnea score 4 | 20/122 (16.4%) | 15/72 (20.8%) | 1/20 (5.0%) | 4/30 (13.3%) |
| NYHA FC, initial visit | 3 (2, 3)* (n = 85) | 3 (2, 3)* (n = 51) | 2 (1, 2.5)* (n = 12) | 2.5 (2, 3)* (n = 22) |
| NYHA FC 0 | 1/85 (1.2%) | 0/51 (0%) | 0/12 (0%) | 0/22 (4.6%) |
| NYHA FC 1 | 8/85 (9.4%) | 3/51 (5.9%) | 4/12 (33.3%) | 1/22 (4.6%) |
| NYHA FC 2 | 28/85 (32.9%) | 14/51 (27.4%) | 5/12 (41.7%) | 9/22 (40.9%) |
| NYHA FC 3 | 37/85 (43.5%) | 27/51 (52.9%) | 3/12 (25.0%) | 7/22 (31.8%) |
| NYHA FC 4 | 11/85 (12.9%) | 7/51 (13.7%) | 0/12 (0%) | 4/22 (18.2%) |
| Jugular venous distention, initial visit | 42/125 (33.6%) | 25/73 (34.2%) | 6/21 (28.6%) | 11/31 (35.5%) |
| Peripheral edema | 62/125 (49.6%) | 40/73 (54.8%) | 8/21 (38.1%) | 14/31 (45.2%) |
| Medical history | ||||
| History of anemia | 41/125 (32.8%) | 25/73 (34.2%) | 3/21 (14.3%) | 13/31 (41.9%) |
| History of congenital heart disease | 4/125 (3.2%) | 2/73 (2.7%) | 1/21 (4.8%) | 1/31 (3.2%) |
| History of valvular heart disease | 24/125 (19.2%) | 15/73 (20.6%) | 7/21 (33.3%) | 2/31 (6.5%) |
| History of diabetes | 42/125 (33.6%) | 30/73 (41.1%) | 8/21 (38.1%) | 4/31 (12.9%) |
| History of systemic hypertension | 77/125 (61.6%) | 48/73 (65.8%) | 12/21 (57.1%) | 17/31 (54.8%) |
| History of anorexigen use | 7/125 (5.6%) | 5/73 (6.8%) | 1/21 (4.8%) | 1/31 (3.2%) |
| History of bleeding disorder, GI bleeding, or epistaxis | 27/125 (21.6%) | 16/73 (21.9%) | 3/21 (14.3%) | 8/31 (25.8%) |
| History of cancer | 35/125 (28%) | 25/73 (34.2%) | 6/21 (28.6%) | 4/31 (12.9%) |
| History of heart failure | 55/1125 (44%) | 37/73 (51%) | 7/21 (33.3%) | 11/31 (35.5%) |
| History of connective tissue disease | 9/125 (7.2%) | 5/73 (6.8%) | 4/21 (19%) | 0/31 (0%) |
| History of CAD | 61/125 (48.8%) | 43/73 (58.9%) | 7/21 (33.3%) | 11/31 (35.5%) |
| History of COPD | 75/125 (60%) | 47/73 (64.4%) | 9/21 (43%) | 19/31 (61.3%) |
| History of DVT/PE | 21/125 (16.8%) | 12/73 (16.4%) | 3/21 (14.3%) | 6/31 (19.4%) |
| History of heart surgery/CABG | 23/125 (18.4%) | 16/73 (21.9%) | 4/21 (19%) | 3/21 (9.7%) |
| History of HIV infection | 1/125 (0.8%) | 0/73 (0%) | 1/21 (4.8%) | 0/31 (0%) |
| History of liver disease | 13/125 (10.4%) | 9/73 (12.3%) | 2/21 (9.5%) | 2/31 (6.4%) |
| History of OSA | 59/125 (47.2%) | 41/73 (56.2%) | 9/21 (42.9%) | 9/31 (29%) |
| History of pulmonary fibrosis | 13/125 (10.4%) | 8/73 (11.0%) | 3/21 (14.3%) | 2/31 (6.4%) |
| History of rheumatic fever/heart disease | 3/125 (2.4%) | 2/73 (2.7%) | 0/21 (0%) | 1/31 (3.2%) |
| History of sickle cell trait or disease, or thalassemia | 0/125 (0%) | 0/73 (0%) | 0/21 (0%) | 0/31 (0%) |
| History of thyroid disease | 8/125 (6.4%) | 7/73 (9.6%) | 1/21 (4.8%) | 0/31 (0%) |
| History of splenectomy | 1/125 (0.8%) | 1/73 (1.4%) | 0/21 (0%) | 0/31 (0%) |
| History of myeloproliferative disease | 1/125 (0.8%) | 1/73 (1.4%) | 0/21 (0%) | 0/31 (0%) |
| Ever smokers | 108/125 (86.4%) | 66/73 (90.4%) | 16/21 (76.2%) | 26/31 (83.9%) |
| Current smokers | 19/125 (15.2%) | 16/73 (21.9%) | 1/21 (4.8%) | 2/31 (6.5%) |
| Former smokers | 89/125 (71.2%) | 50/73 (68.5%) | 15/21 (71.4%) | 24/31 (77.4%) |
| Never smokers | 17/125 (13.6%) | 7/73 (9.6%) | 5/21 (23.8%) | 5/31 (16.1%) |
| Functional capacity | ||||
| 6MWD (feet) | 906 (339) (n = 71) | 897 (281) (n = 53) | 1220 (458) (n = 9) | 645 (301) (n = 9) |
| 6MWD (m) | 309 (115) (n = 71) | 306 (96) (n = 53) | 416 (156) (n = 9) | 220 (103) (n = 9) |
| Pulmonary function tests | ||||
| Forced expiratory volume in 1 s (FEV1), % | 67 (23) (n = 116) | 65 (21) (n = 69) | 76 (20) (n = 19) | 67 (30) (n = 28) |
| Forced vital capacity (FVC), % | 80 (20) (n = 116) | 78 (19) (n = 69) | 89 (17) (n = 19) | 77 (24) (n = 28) |
| FEV1/FVC ratio | 62 (15) (n = 115) | 61 (14) (n = 69) | 64 (18) (n = 19) | 62 (17) (n = 27) |
| Total lung capacity (TLC), % | 85 (17) (n = 110) | 83 (16) (n = 66) | 94 (18) (n = 18) | 84 (20) (n = 26) |
| Diffusion capacity of the lungs for carbon monoxide, % | 52 (21) (n = 111) | 48 (20) (n = 66) | 61 (24) (n = 19) | 55 (22) (n = 26) |
| Airflow obstruction (FEV/FVC < 70%) | 75/115 (65.2%) | 49/69 (71%) | 10/19 (52.6%) | 16/27 (59.3%) |
| Restriction (TLC < 80%) | 41/110 (37.3%) | 28/66 (42%) | 3/18 (16.7%) | 10/26 (38.5%) |
| Mixed obstruction and restriction | 21/110 (19.1%) | 14/66 (21.2%) | 1/17 (5.6%) | 6/26 (23.1%) |
| Echocardiography | ||||
| Right atrial enlargement | 60/123 (48.8%) | 41/73 (56.2%) | 9/20 (45%) | 10/30 (33.3%) |
| Right ventricular hypertrophy | 9/123 (7.3%) | 6/73 (8.2%) | 0/20 (0%) | 3/30 (10%) |
| Systolic septal flattening | 24/123 (19.5%) | 19/73 (26%) | 1/20 (5%) | 4/30 (13.3%) |
| Tricuspid plane annular systolic excursion (cm) | 2.0 (0.6) (n = 108) | 1.9 (0.6) (n = 63) | 2.1 (0.6) (n = 16) | 2.1 (0.6) (n = 29) |
| Left atrial size volume index | 28.9 (13.4) (n = 105) | 29.8 (15.2) (n = 61) | 26.3 (9.5) (n = 17) | 28.6 (11.1) (n = 27) |
| Left ventricular ejection fraction (%) | 57 (7) (n = 125) | 56 (8) (n = 73) | 58 (4) (n = 21) | 58 (6) (n = 31) |
| Reduced left ventricular ejection fraction (<50%) | 11/125 (8.8%) | 9/73 (12.3%) | 0/21 (0%) | 2/31 (6.4%) |
| Left ventricular diastolic dysfunction present | 46/123 (37.4%) | 25/73 (34.2%) | 8/20 (40%) | 13/30 (43%) |
| Pericardial effusion present | 4/123 (3.2%) | 3/73 (4.1%) | 0/20 (0%) | 1/30 (3.3%) |
| Aortic stenosis | 16/123 (13.0%) | 12/73 (16.4%) | 1/20 (5%) | 3/30 (10%) |
| Aortic stenosis severity† | 1 4/16 (25%) | 1 4/12 (33.3%) | 1 0/1 (0%) | 1 0/3 (0%) |
| 2 2/16 (12.5%) | 2 2/12 (16.7%) | 2 0/1 (0%) | 2 0/3 (0%) | |
| 3 5/16 (31.2%) | 3 3/12 (25%) | 3 1/1 (100%) | 3 1/3 (33%) | |
| 4 2/16 (12.5%) | 4 0/12 (0%) | 4 0/1 (0%) | 4 2/3 (33%) | |
| 5 3/16 (18.8%) | 5 3/12 (25%) | 5 0/1 (0%) | 5 0/3 (0%) | |
| Aortic regurgitation | 37/123 (30.1%) | 24/73 (32.9%) | 6/14 (30%) | 7/30 (23.3%) |
| Aortic regurgitation severity† | 1 33/38 (86.8%) | 1 21/24 (87.5%) | 1 6/7 (85.7%) | 1 6/7 (85.7%) |
| 2 3/38 (7.9%) | 2 2/24 (8.3%) | 2 1/7 (14.3%) | 2 0/7 (0%) | |
| 3 2/38 (5.3%) | 3 1/24 (4.2%) | 3 0/7 (0%) | 3 1/7 (14.3%) | |
| Mitral stenosis | 2/123 (1.6%) | 0/73 (0%) | 0/20 (0%) | 2/30 (6.7%) |
| Mitral stenosis severity† | 1 2/2 (100%) | NA | NA | 1 2/2 (100%) |
| Mitral regurgitation | 58/123 (47.2%) | 35/73 (48%) | 10/20 (50%) | 13/30 (43.3%) |
| Mitral regurgitation severity† | 1 50/60 (83.3%) | 1 30/37 (81.1%) | 1 9/10 (90%) | 1 11/13 (84.6%) |
| 2 3/60 (5.0%) | 2 3/37 (8.1%) | 2 0/10 (0%) | 2 0/13 (0%) | |
| 3 3/60 (5.0%) | 3 2/37 (5.4%) | 3 1/10 (10%) | 3 0/13 (0%) | |
| 4 1/60 (1.7%) | 4 1/37 (2.7%) | 4 0/10 (0%) | 4 0/13 (0%) | |
| 5 3/60 (5.0%) | 5 1/37 (2.7%) | 5 0/10 (0%) | 5 2/13 (15.4%) | |
| Tricuspid regurgitation | 90/123 (73.2%) | 52/73 (71.2%) | 18/20 (90%) | 20/30 (66.7%) |
| Tricuspid regurgitation severity† | 1 53/91 (58.2%) | 1 31/53 (58.5%) | 1 12/18 (66.7%) | 1 10/20 (50%) |
| 2 6/91 (6.6%) | 2 3/53 (5.7%) | 2 0/18 (0%) | 2 3/20 (15%) | |
| 3 13/91 (14.3%) | 3 9/53 (17.0%) | 3 2/18 (11.1%) | 3 2/20 (10%) | |
| 4 6/91 (6.6%) | 4 4/53 (7.6%) | 4 0/18 (22.2%) | 4 2/20 (10%) | |
| 5 13/91 (14.3%) | 5 6/53 (11.3%) | 5 4/18 (22.2%) | 5 3/20 (15%) | |
| Estimated right ventricular systolic pressure (mmHg) | 47 (13) (n = 90) | 49 (13) (n = 56) | 43 (10) (n = 15) | 44 (12) (n = 19) |
| Right ventricular systolic pressure ≥ 40 mmHg | 71/90 (78.9%) | 49/56 (87.5%) | 9/15 (60.0%) | 13/19 (68.4%) |
| Right ventricular systolic pressure ≥ 60 mmHg | 20/90 (22.2%) | 16/56 (28.6%) | 0/15 (0%) | 4/19 (21.0%) |
Mean (SD) or ratio (%), unless otherwise noted.
*
Median (IQR)
†
1 = mild; 2 = mild to moderate; 3 = moderate; 4 = moderate to severe; 5 = severe.