Significance of Hypocapnia in the Risk Assessment of Patients with Pulmonary Hypertension
Blood gas analysis is part of the diagnostic work−up for pulmonary hypertension (PH). Although some studies have found that the partial pressure of carbon dioxide (PaCO2) is an independent marker of mortality in individuals with pulmonary arterial hypertension (PH Group 1), there is a lack of data r...
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| Veröffentlicht in: | Journal of clinical medicine 2023-09, Vol.12 (19), p.6307 |
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| description | Blood gas analysis is part of the diagnostic work−up for pulmonary hypertension (PH). Although some studies have found that the partial pressure of carbon dioxide (PaCO2) is an independent marker of mortality in individuals with pulmonary arterial hypertension (PH Group 1), there is a lack of data regarding the significance of PaCO2 in individuals with different types of PH based on the new 2022 definitions. Therefore, this study analyzed data from 157 individuals who were undergoing PH work−up, including right heart catheterization, using PH definitions from the 2022 European Society of Cardiology/European Respiratory Society guidelines. At diagnosis, N−terminal pro−B−type natriuretic peptide (NT−pro−BNP) levels were significantly higher, but the time−course of NT−pro−BNP levels during treatment was significantly more favorable in individuals with pulmonary arterial hypertension (PH Group 1) who did versus did not have hypocapnia (p = 0.026 and p = 0.017, respectively). These differences based on the presence of hypocapnia were not seen in individuals with PH Groups 2, 3, or 4. In conclusion, using the new definition of PH, hypocapnia may correlate with worse risk stratification at diagnosis in individuals with pulmonary arterial hypertension. However, hypocapnic individuals with pulmonary arterial hypertension may benefit more from disease−specific therapy than those without hypocapnia. |
| doi_str_mv | 10.3390/jcm12196307 |
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Although some studies have found that the partial pressure of carbon dioxide (PaCO2) is an independent marker of mortality in individuals with pulmonary arterial hypertension (PH Group 1), there is a lack of data regarding the significance of PaCO2 in individuals with different types of PH based on the new 2022 definitions. Therefore, this study analyzed data from 157 individuals who were undergoing PH work−up, including right heart catheterization, using PH definitions from the 2022 European Society of Cardiology/European Respiratory Society guidelines. At diagnosis, N−terminal pro−B−type natriuretic peptide (NT−pro−BNP) levels were significantly higher, but the time−course of NT−pro−BNP levels during treatment was significantly more favorable in individuals with pulmonary arterial hypertension (PH Group 1) who did versus did not have hypocapnia (p = 0.026 and p = 0.017, respectively). These differences based on the presence of hypocapnia were not seen in individuals with PH Groups 2, 3, or 4. In conclusion, using the new definition of PH, hypocapnia may correlate with worse risk stratification at diagnosis in individuals with pulmonary arterial hypertension. However, hypocapnic individuals with pulmonary arterial hypertension may benefit more from disease−specific therapy than those without hypocapnia.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12196307</identifier><identifier>PMID: 37834951</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Analysis ; Blood gas analysis ; Blood gases ; Cardiac catheterization ; Clinical medicine ; Diagnosis ; Ethics ; Heart ; Hemodynamics ; Intubation ; Lung diseases ; Mortality ; Patients ; Peptides ; Pulmonary arteries ; Pulmonary hypertension ; Pulmonary manifestations of general diseases ; Risk assessment ; Risk factors ; Statistical analysis ; Variables</subject><ispartof>Journal of clinical medicine, 2023-09, Vol.12 (19), p.6307</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-e41b27559e01f3206a38b9591b13fc244cb6e0d63802b409e6127d8b4fae240f3</citedby><cites>FETCH-LOGICAL-c454t-e41b27559e01f3206a38b9591b13fc244cb6e0d63802b409e6127d8b4fae240f3</cites><orcidid>0009-0008-4920-4107 ; 0000-0002-2088-8129 ; 0000-0002-3452-5329</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573368/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573368/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Aetou, Maria</creatorcontrib><creatorcontrib>Wahab, Lora</creatorcontrib><creatorcontrib>Dreher, Michael</creatorcontrib><creatorcontrib>Daher, Ayham</creatorcontrib><title>Significance of Hypocapnia in the Risk Assessment of Patients with Pulmonary Hypertension</title><title>Journal of clinical medicine</title><description>Blood gas analysis is part of the diagnostic work−up for pulmonary hypertension (PH). Although some studies have found that the partial pressure of carbon dioxide (PaCO2) is an independent marker of mortality in individuals with pulmonary arterial hypertension (PH Group 1), there is a lack of data regarding the significance of PaCO2 in individuals with different types of PH based on the new 2022 definitions. Therefore, this study analyzed data from 157 individuals who were undergoing PH work−up, including right heart catheterization, using PH definitions from the 2022 European Society of Cardiology/European Respiratory Society guidelines. At diagnosis, N−terminal pro−B−type natriuretic peptide (NT−pro−BNP) levels were significantly higher, but the time−course of NT−pro−BNP levels during treatment was significantly more favorable in individuals with pulmonary arterial hypertension (PH Group 1) who did versus did not have hypocapnia (p = 0.026 and p = 0.017, respectively). These differences based on the presence of hypocapnia were not seen in individuals with PH Groups 2, 3, or 4. In conclusion, using the new definition of PH, hypocapnia may correlate with worse risk stratification at diagnosis in individuals with pulmonary arterial hypertension. However, hypocapnic individuals with pulmonary arterial hypertension may benefit more from disease−specific therapy than those without hypocapnia.</description><subject>Analysis</subject><subject>Blood gas analysis</subject><subject>Blood gases</subject><subject>Cardiac catheterization</subject><subject>Clinical medicine</subject><subject>Diagnosis</subject><subject>Ethics</subject><subject>Heart</subject><subject>Hemodynamics</subject><subject>Intubation</subject><subject>Lung diseases</subject><subject>Mortality</subject><subject>Patients</subject><subject>Peptides</subject><subject>Pulmonary arteries</subject><subject>Pulmonary hypertension</subject><subject>Pulmonary manifestations of general diseases</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Variables</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkl1LHDEUhoNUqqhX_QMD3hTK2nxNPq7KItUtCBW1F70KmezJbtaZZDuZqfjvzeBSP2hykUPyvO85JxyEPhF8xpjGXzeuI5RowbDcQ4cUSznDTLEPr-IDdJLzBpelFKdEfkQHTCrGdU0O0e_bsIrBB2ejgyr5avG4Tc5uY7BViNWwhuom5PtqnjPk3EEcJujaDqGEuXoIw7q6HtsuRds_TmLoB4g5pHiM9r1tM5zsziP06-L73flidvXz8sf5_GrmeM2HGXDSUFnXGjDxjGJhmWp0rUlDmHeUc9cIwEvBFKYNxxoEoXKpGu4tUI49O0Lfnn23Y9PB0pW6etuabR-6UpJJNpi3LzGszSr9NQTXkjGhisPnnUOf_oyQB9OF7KBtbYQ0ZkOVlOWvheYFPX2HbtLYx9LfRImaaSnEC7WyLZgQfSqJ3WRq5lKWHrmidaHO_kOVvYQuuBTBh3L_RvDlWeD6lHMP_l-TBJtpGsyraWBPXBKkbg</recordid><startdate>20230930</startdate><enddate>20230930</enddate><creator>Aetou, Maria</creator><creator>Wahab, Lora</creator><creator>Dreher, Michael</creator><creator>Daher, Ayham</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0009-0008-4920-4107</orcidid><orcidid>https://orcid.org/0000-0002-2088-8129</orcidid><orcidid>https://orcid.org/0000-0002-3452-5329</orcidid></search><sort><creationdate>20230930</creationdate><title>Significance of Hypocapnia in the Risk Assessment of Patients with Pulmonary Hypertension</title><author>Aetou, Maria ; Wahab, Lora ; Dreher, Michael ; Daher, Ayham</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-e41b27559e01f3206a38b9591b13fc244cb6e0d63802b409e6127d8b4fae240f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analysis</topic><topic>Blood gas analysis</topic><topic>Blood gases</topic><topic>Cardiac catheterization</topic><topic>Clinical medicine</topic><topic>Diagnosis</topic><topic>Ethics</topic><topic>Heart</topic><topic>Hemodynamics</topic><topic>Intubation</topic><topic>Lung diseases</topic><topic>Mortality</topic><topic>Patients</topic><topic>Peptides</topic><topic>Pulmonary arteries</topic><topic>Pulmonary hypertension</topic><topic>Pulmonary manifestations of general diseases</topic><topic>Risk assessment</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aetou, Maria</creatorcontrib><creatorcontrib>Wahab, Lora</creatorcontrib><creatorcontrib>Dreher, Michael</creatorcontrib><creatorcontrib>Daher, Ayham</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aetou, Maria</au><au>Wahab, Lora</au><au>Dreher, Michael</au><au>Daher, Ayham</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significance of Hypocapnia in the Risk Assessment of Patients with Pulmonary Hypertension</atitle><jtitle>Journal of clinical medicine</jtitle><date>2023-09-30</date><risdate>2023</risdate><volume>12</volume><issue>19</issue><spage>6307</spage><pages>6307-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Blood gas analysis is part of the diagnostic work−up for pulmonary hypertension (PH). Although some studies have found that the partial pressure of carbon dioxide (PaCO2) is an independent marker of mortality in individuals with pulmonary arterial hypertension (PH Group 1), there is a lack of data regarding the significance of PaCO2 in individuals with different types of PH based on the new 2022 definitions. Therefore, this study analyzed data from 157 individuals who were undergoing PH work−up, including right heart catheterization, using PH definitions from the 2022 European Society of Cardiology/European Respiratory Society guidelines. At diagnosis, N−terminal pro−B−type natriuretic peptide (NT−pro−BNP) levels were significantly higher, but the time−course of NT−pro−BNP levels during treatment was significantly more favorable in individuals with pulmonary arterial hypertension (PH Group 1) who did versus did not have hypocapnia (p = 0.026 and p = 0.017, respectively). These differences based on the presence of hypocapnia were not seen in individuals with PH Groups 2, 3, or 4. In conclusion, using the new definition of PH, hypocapnia may correlate with worse risk stratification at diagnosis in individuals with pulmonary arterial hypertension. However, hypocapnic individuals with pulmonary arterial hypertension may benefit more from disease−specific therapy than those without hypocapnia.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>37834951</pmid><doi>10.3390/jcm12196307</doi><orcidid>https://orcid.org/0009-0008-4920-4107</orcidid><orcidid>https://orcid.org/0000-0002-2088-8129</orcidid><orcidid>https://orcid.org/0000-0002-3452-5329</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Blood gas analysis Blood gases Cardiac catheterization Clinical medicine Diagnosis Ethics Heart Hemodynamics Intubation Lung diseases Mortality Patients Peptides Pulmonary arteries Pulmonary hypertension Pulmonary manifestations of general diseases Risk assessment Risk factors Statistical analysis Variables |
| title | Significance of Hypocapnia in the Risk Assessment of Patients with Pulmonary Hypertension |
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