Ashur Avia, Levy Amalia, Liel-Cohen Noah, Sergienko Ruslan, Kobal Sergio L
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel.
Soroka University Medical Center, Beer Sheva 8410501, Israel.
J Clin Med. 2025 Jul 16;14(14):5044. doi: 10.3390/jcm14145044.
: The global prevalence of pulmonary hypertension (PHT) among the elderly population aged 65 years and above is estimated to be 10%. While it is known to be associated with poor prognoses in patients with cardiovascular or pulmonary diseases, the significance of PHT as an incidental finding among individuals without these conditions remains unclear. The aim of this study was to investigate the relationship between incidental PHT detected by echocardiography and long-term all-cause mortality in patients without known cardiovascular or pulmonary diseases. : This retrospective, single-center cohort study included 8283 patients who underwent two consecutive echocardiographic examinations evaluating pulmonary pressure by assessing the maximal velocity of the tricuspid regurgitation jet. In total, 1705 (20.6%) patients were found to have PHT during the first echocardiography. Using a Cox proportional hazard model for all-cause mortality, PHT was found to be a significant and independent risk factor for all-cause mortality, increasing the risk by 34% (Adj. HR-1.34, 95% CI 1.21-1.47, < 0.001). There was a direct relationship between PHT severity and long-term all-cause mortality, with patients with severe PHT having a two-fold higher risk compared to those with normal pulmonary blood pressure (Adj. HR-2, 95% CI: 1.58-2.54, < 0.001). A "cutoff point" of sPAP > 40 mmHg was established, where pulmonary pressure values remained high and even worsened over time ( < 0.001). : The incidental diagnosis of PHT by echocardiography in patients without known cardiovascular or pulmonary diseases is an independent risk factor for long-term all-cause mortality. Patients with sPAP ≥ 40 mmHg warrant a comprehensive clinical assessment.
据估计,65岁及以上老年人群中肺动脉高压(PHT)的全球患病率为10%。虽然已知其与心血管或肺部疾病患者的不良预后相关,但PHT在无这些疾病的个体中作为偶然发现的意义仍不明确。本研究的目的是调查在无已知心血管或肺部疾病的患者中,经超声心动图检测出的偶然PHT与长期全因死亡率之间的关系。 :这项回顾性、单中心队列研究纳入了8283例患者,他们接受了两次连续的超声心动图检查,通过评估三尖瓣反流射流的最大速度来评估肺动脉压力。总共,1705例(20.6%)患者在第一次超声心动图检查时被发现患有PHT。使用Cox比例风险模型评估全因死亡率,发现PHT是全因死亡率的一个显著且独立的风险因素,风险增加34%(调整后风险比-1.34,95%置信区间1.21-1.47,P<0.001)。PHT严重程度与长期全因死亡率之间存在直接关系,重度PHT患者的风险是肺血压正常患者的两倍(调整后风险比-2,95%置信区间:1.58-2.54,P<0.001)。确定了收缩期肺动脉压(sPAP)>40 mmHg的“临界点”,在此处肺动脉压力值持续升高甚至随时间恶化(P<0.001)。 :在无已知心血管或肺部疾病的患者中,经超声心动图偶然诊断出的PHT是长期全因死亡率的独立风险因素。sPAP≥40 mmHg的患者需要进行全面的临床评估。