Pulmonary hypertension due to left heart disease: diagnostic value of pulmonary artery distensibility

Background Heart failure is a severe condition often involving pulmonary hypertension (PH). Soluble low-density lipoprotein receptor with 11 ligand-binding repeats (sLR11) has been associated with pulmonary artery hypertension. We examined whether sLR11 correlates with PH in left heart disease and can be used as a predictive marker. Method We retrospectively analyzed patients with severe mitral regurgitation who underwent right heart catheterization before surgery for valve replacement or valvuloplasty from November 2005 to October 2012 at Juntendo University. We measured sLR11 levels before right heart catheterization and analyzed correlations with pulmonary hemodynamics. We compared prognoses between a group with normal sLR11 (≤9.4 ng/ml) and a group with high sLR11 (>9.4 ng/ml). Follow-up was continued for 5 years, with end points of hospitalization due to HF and death due to cardiovascular disease. Results Among 34 patients who met the inclusion criteria, sLR11 correlated with mean pulmonary artery pressure (r = 0.54, p<0.001), transpulmonary pressure gradient (r = 0.42, p = 0.012), pulmonary vascular resistance (r = 0.36, p<0.05), and log brain natriuretic peptide (BNP). However, logBNP did not correlate with pulmonary vascular resistance (p = 0.6). Levels of sLR11 were significantly higher in the 10 patients with PH (14.4±4.3 ng/ml) than in patients without PH (9.9±3.9 ng/ml; p = 0.002). At 5 years, the event rate was higher in the high-sLR11 group than in the normal-sLR11 group. The high-sLR11 group showed 5 hospitalizations due to HF (25.0%) and 2 deaths (10.0%), whereas the normal-sLR11 group showed no hospitalizations or deaths. Analyses using receiver operating characteristic curves showed a higher area under the concentration-time curve (AUC) for sLR11 level (AUC = 0.85; 95% confidence interval (CI) = 0.72–0.98) than for BNP (AUC = 0.80, 95%CI = 0.62–0.99) in the diagnosis of PH in left heart disease. Conclusions Concentration of sLR11 is associated with severity of PH and offers a strong predictor of severe mitral regurgitation in patients after surgery.

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Characterization of a Pulmonary Hypertension Model Caused by Left Heart Disease in Mouse

10.1055/s-0040-1705471 ◽

2020 ◽

Author(s):

L. K. Pallos ◽

J. M. Dietrich ◽

A. Simon ◽

E. Carls ◽

M. Matthey ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Heart Disease ◽

Left Heart ◽

Left Heart Disease

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Faculty Opinions recommendation of Pulmonary veins in the normal lung and pulmonary hypertension due to left heart disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718110406.793484288 ◽

2013 ◽

Author(s):

Vinicio de Jesus Perez

Keyword(s):

Pulmonary Hypertension ◽

Heart Disease ◽

Pulmonary Veins ◽

Normal Lung ◽

Left Heart ◽

Left Heart Disease

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Roundtable: Pulmonary Hypertension Due to Left Heart Disease

Advances in Pulmonary Hypertension ◽

10.21693/1933-088x-14.2.105 ◽

2015 ◽

Vol 14 (2) ◽

pp. 105-110

Keyword(s):

Pulmonary Hypertension ◽

Heart Disease ◽

Guest Editor ◽

Mayo Clinic ◽

Diagnosis And Treatment ◽

Left Heart ◽

Health Network ◽

University Of Utah ◽

School Of Medicine ◽

Left Heart Disease

Guest editor Teresa De Marco, MD, along with Brian Shapiro, MD, Mayo Clinic, Jacksonville, FL, convened a panel of experts to discuss the challenges in diagnosis and treatment and the emerging science regarding pulmonary hypertension due to left heart disease. Contributing to the engaging discussion were James Fang, MD, University of Utah School of Medicine; Barry Borlaug, MD, Mayo Clinic, Rochester, MN; and Srinivas Murali, MD, Allegheny Health Network, Pittsburgh, PA.

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