Pulmonary vascular disease & thromboembolismCross-sectional study

Right Heart Failure as a Cause of Pulmonary Congestion in Pulmonary Arterial Hypertension

Eur J Heart FailPublished

  • Cross-sectional study
  • single-centre

Authors' conclusion

Lung ultrasound commonly discloses pulmonary congestion in PAH. This finding is related to right ventricular to pulmonary artery uncoupling, and may tentatively be explained by increased central venous pressure impeding lymphatic outflow.

Study context

Population
Patients with idiopathic PAH referred to a tertiary centre, January 2020 to December 2022
Participants
102 patients
Outcome
Pulmonary congestion by lung ultrasound B-lines (8-site scan)

Main finding

As reported in the abstract

B-lines on lung ultrasound
Patients with B-lines
77 out of 102 patients (75%)
Number of B-lines, median [IQR]
3 [IQR 1-5]
Independent predictor of B-lines: Right atrial pressure (RAP)
p < 0.001
Independent predictor of B-lines: Tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP)
p = 0.001
Independent predictor of B-lines: N-terminal pro-brain natriuretic peptide (NT-proBNP)
p = 0.04

Observational data: associations, not effects.

Further findings

Univariable correlates of B-lines

Positive correlation with male sex, age, NT-proBNP, sPAP, RAP, pulmonary vascular resistance (PVR), LV end-diastolic volume and TAPSE; negative with cardiac output and stroke volume

Original publication

Right Heart Failure as a Cause of Pulmonary Congestion in Pulmonary Arterial Hypertension. Eur J Heart Fail. Published 26 February 2024. doi:10.1002/ejhf.3172

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