Abstract 12791: Right Ventricular End Diastolic Pressure to Pulmonary Arterial Wedge Pressure is Associated With Mortality in Patients With Pulmonary Hypertension

BackgroundPulmonary hypertension (PH) is a progressive condition characterized by elevated right ventricular (RV) pressure leading to deleterious interventricular interactions including left ventricular (LV) diastolic compression. There is paucity of data on the relationship of these hemodynamic/structural Interventricular interactions with clinical outcomes in PH.HypothesisWe hypothesized that in PH, an increase in the ratio of RV end diastolic pressure (RVEDP) to pulmonary arterial wedge pressure (PAWP), RVEDP/PAWP, would be associated with corresponding structural changes in RV end diastolic dimension (RVIDd), LV end diastolic dimension (LVIDd), and that both RVEDP/PAWP and RVIDd/LVIDd ratios would be associated with increased mortality.MethodsThis was a retrospective study of consecutive patients of all groups of PH in an outpatient setting at a tertiary academic center (from 2012-2017).Multivariable Cox proportional hazards regression and Kaplan-Meier survival analysis were used to assess the association of RVEDP/PAWP ratio with mortality. Correlational analysis was made to assess the relationship between RVEDP/PAWP and RVIDd/LVIDd.ResultsAmong 116 patients (mean age 64 years +/- 13 and 68% female), each unit increase in the RVEDP/PAWP ratio was associated with over a three-fold increase in mortality (HR 3.386, 95% Cl 1.465-7.828). In the multivariable logistic regression model adjusted for the RVIDd/LVIDd, each unit increase in the RVEDP/PAWP was still significantly associated with mortality. There was a weak correlation (p