Heart failure & cardiomyopathiesCohort study

Post-capillary pulmonary hypertension in heart failure: impact of current definition in the PH-HF multicentre study

Eur Heart JPublished

  • Prospective cohort study
  • multicentre

Authors' conclusion

This study is the first emphasizing the impact of the new pcPH definition on CpcPH prevalence and validating the prognostic value of mPAP > 20 mmHg and PVR > 2 WU among HF patients.

Study context

Population
Stable left heart failure (HF) patients needing right heart catheterization, enrolled 2010–2018
Participants
662 patients
Exposure
Post-capillary pulmonary hypertension (pcPH) definitions and prognostic value of mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR)
Outcome
All-cause death or hospitalization for HF

Main finding

As reported in the abstract

All-cause death or HF hospitalisation (multivariable Cox)
multivariable
Hazard ratio (95% CI)P value
mPAP
1.02(1.00–1.03)
P = 0.01
PVR
1.07(1.00–1.14)
P = 0.03
2022 definition: worse survival with pcPH vs no pcPH (log-rank)
P = 0.02
2022 definition: worse survival with CpcPH vs IpcPH (log-rank)
P = 0.003

Observational data: associations, not effects.

Further findings

OutcomeP value
Survival by 2022 definition — pcPH vs No pcPH · worse survival with pcPHP = 0.02
Survival by 2022 definition — CpcPH vs IpcPH · worse survival with CpcPHP = 0.003

pcPH and CpcPH prevalence with lowered thresholds

Lowering mPAP from 25 to 20 mmHg: increase in pcPH prevalence
+10%
Lowering PVR from 3 to 2: increase in CpcPH prevalence (significant net reclassification improvement for primary outcome)
+60%

Original publication

Post-capillary pulmonary hypertension in heart failure: impact of current definition in the PH-HF multicentre study. Eur Heart J. Published 26 July 2024. doi:10.1093/eurheartj/ehae467

Summarised from the published abstract; every number is checked against it