Pulmonary vascular disease & thromboembolism

Inhaled Nitric Oxide Testing in Predicting Prognosis in Pulmonary Hypertension Due to Left-Sided Heart Diseases

ESC Heart FailPublished Retrospective cohort study

Main finding · All-cause death or hospitalization for HFResult — go to the resultHazard ratio 4.35 95% CI 1.27–14.83

Authors' conclusion

Patients with Group 2 PH were tolerant of the inhaled NO test. NO-induced PAWP is a novel prognostic indicator.

Study context

Population
Patients with PH due to left-sided heart disease (Group 2 PH; mean pulmonary arterial pressure ≥25 mmHg, pulmonary arterial wedge pressure (PAWP) >15 mmHg), 2011–2015median follow-up 365 days
Participants
69 patients
Exposure
Increased PAWP vs no increased PAWP after inhaled nitric oxide (NO) vasoreactivity test
  • Increased PAWPn = 34
  • No increase in PAWPn = 35reference
Outcome
All-cause death or hospitalization for heart failure (HF)
Follow-up
1 year
Methodological detailssingle-centre
  • Single-centre

Main finding

As reported in the abstract

Hazard ratio

4.35

95% CI 1.27–14.83

P = 0.019

Increased PAWPvs No increase in PAWP
HR 4.35 (95% CI 1.27–14.83); P = 0.019

Observational data: associations, not effects.

Further findings

Acute response of PAWP to NO differed between HFpEF and HFrEF

Safety

No adverse events observed after NO inhalation

Original publication

Inhaled Nitric Oxide Testing in Predicting Prognosis in Pulmonary Hypertension Due to Left-Sided Heart Diseases. ESC Heart Fail. Published 29 September 2023. doi:10.1002/ehf2.14515

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