Zdenka Fingrova1, David Ambroz1, Pavel Jansa1, Jan Kuchar1,2, Jaroslav Lindner3, Jan Kunstyr4, Michael Aschermann1, Ales Linhart1, Stepan Havranek1. 1. 1stFaculty of Medicine, 2nd Department of Medicine-Department of Cardiovascular Medicine, General University Hospital, Charles University, Prague, Czech Republic. 2. Regional Hospital in Tabor, Tabor, Czech Republic. 3. 1st Faculty of Medicine, 2nd Department of Surgery-Department of Cardiovascular Surgery, General University Hospital, Charles University, Prague, Czech Republic. 4. 1st Faculty of Medicine, Department of Anaesthesiology, Resuscitation and Intensive Medicine, General University Hospital, Charles University, Prague, Czech Republic.
Abstract
PURPOSE: Patients with pulmonary hypertension (PH) frequently suffer from supraventricular tachycardias (SVT). The main purpose of our study was to identify the cumulative incidence of SVT in patients with different etiologies of PH. The secondary objective was to analyse the clinical impact of SVT. METHODS: We retrospectively studied the prevalence of SVT and the clinical outcome in 755 patients (41% males; 60 ± 15 years; mean follow-up 3.8 ± 2.8 years) with PH of different etiologies. The prevalence of SVT was analysed separately in isolated pre-capillary PH (Ipc-PH) and in patients with combined post- and pre-capillary PH (Cpc-PH). RESULTS: The prevalence of SVT in the Ipc-PH group (n = 641) was 25% (n = 162). The most prevalent arrhythmias were atrial fibrillation followed by a typical atrial flutter (17% and 4.4% of all Icp-PH patients). An excessive prevalence of SVT was found in patients with pulmonary arterial hypertension associated with congenital heart disease (35%, p = 0.01). Out of the overall study population, Cpc-PH was present in 114 (15%) patients. Patients with Cpc-PH manifested a higher prevalence of SVT than subjects with Ipc-PH (58; 51% vs. 162; 25%; p <0.0001) and were more likely to have persistent or permanent atrial fibrillation (38; 29% vs. 61; 10%; p <0.0001). Parameters significantly associated with mortality in a multivariate analysis included age, male gender, functional exercise capacity and right atrial diameter (p < 0.05). Neither diagnosis of SVT nor type of arrhythmia predicted mortality. CONCLUSIONS: The study detected a significant prevalence of SVT in the population of PH of different origins. Different spectrum and prevalence of arrhythmia might be expected in different etiologies of PH. Patients with an elevated post-capillary pressure showed a higher arrhythmia prevalence, predominantly due to an excessive number of atrial fibrillations. The diagnosis of SVT was not associated with mortality.
PURPOSE:Patients with pulmonary hypertension (PH) frequently suffer from supraventricular tachycardias (SVT). The main purpose of our study was to identify the cumulative incidence of SVT in patients with different etiologies of PH. The secondary objective was to analyse the clinical impact of SVT. METHODS: We retrospectively studied the prevalence of SVT and the clinical outcome in 755 patients (41% males; 60 ± 15 years; mean follow-up 3.8 ± 2.8 years) with PH of different etiologies. The prevalence of SVT was analysed separately in isolated pre-capillary PH (Ipc-PH) and in patients with combined post- and pre-capillary PH (Cpc-PH). RESULTS: The prevalence of SVT in the Ipc-PH group (n = 641) was 25% (n = 162). The most prevalent arrhythmias were atrial fibrillation followed by a typical atrial flutter (17% and 4.4% of all Icp-PHpatients). An excessive prevalence of SVT was found in patients with pulmonary arterial hypertension associated with congenital heart disease (35%, p = 0.01). Out of the overall study population, Cpc-PH was present in 114 (15%) patients. Patients with Cpc-PH manifested a higher prevalence of SVT than subjects with Ipc-PH (58; 51% vs. 162; 25%; p <0.0001) and were more likely to have persistent or permanent atrial fibrillation (38; 29% vs. 61; 10%; p <0.0001). Parameters significantly associated with mortality in a multivariate analysis included age, male gender, functional exercise capacity and right atrial diameter (p < 0.05). Neither diagnosis of SVT nor type of arrhythmia predicted mortality. CONCLUSIONS: The study detected a significant prevalence of SVT in the population of PH of different origins. Different spectrum and prevalence of arrhythmia might be expected in different etiologies of PH. Patients with an elevated post-capillary pressure showed a higher arrhythmia prevalence, predominantly due to an excessive number of atrial fibrillations. The diagnosis of SVT was not associated with mortality.
Authors: Maria J Ruiz-Cano; Ana Gonzalez-Mansilla; Pilar Escribano; Juan Delgado; Fernando Arribas; Juan Torres; Angela Flox; Marta Riva; Miguel A Gomez; Carlos Saenz Journal: Int J Cardiol Date: 2010-11-05 Impact factor: 4.164
Authors: Nazzareno Galiè; Adam Torbicki; Robyn Barst; Philippe Dartevelle; Sheila Haworth; Tim Higenbottam; Horst Olschewski; Andrew Peacock; Giuseppe Pietra; Lewis J Rubin; Gerald Simonneau; Silvia G Priori; Maria Angeles Alonso Garcia; Jean-Jacques Blanc; Andrzej Budaj; Martin Cowie; Verconcia Dean; Jaap Deckers; Enrique Fernandez Burgos; John Lekakis; Bertil Lindahl; Gianfranco Mazzotta; Keith McGregor; João Morais; Ali Oto; Otto A Smiseth; Joan Albert Barbera; Simon Gibbs; Marius Hoeper; Marc Humbert; Robert Naeije; Joanna Pepke-Zaba Journal: Eur Heart J Date: 2004-12 Impact factor: 29.983
Authors: Jonathan D Rich; Thenappan Thenappan; Benjamin Freed; Amit R Patel; Ronald A Thisted; Rory Childers; Stephen L Archer Journal: Int J Cardiol Date: 2012-03-27 Impact factor: 4.164
Authors: Nazzareno Galiè; Marius M Hoeper; Marc Humbert; Adam Torbicki; Jean-Luc Vachiery; Joan Albert Barbera; Maurice Beghetti; Paul Corris; Sean Gaine; J Simon Gibbs; Miguel Angel Gomez-Sanchez; Guillaume Jondeau; Walter Klepetko; Christian Opitz; Andrew Peacock; Lewis Rubin; Michael Zellweger; Gerald Simonneau Journal: Eur Heart J Date: 2009-08-27 Impact factor: 29.983