Alrahimi Jamilah S, Ismail Yasser, Balubaid Hibah, AlZahrani Atheer, Omar Shuaa, Aljahani Raniyah, Abdulmannan Hawazen, Ahmed Fatima, Jelaidan Ibrahim
Department of Cardiology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
J Cardiovasc Echogr. 2025 Apr-Jun;35(2):142-148. doi: 10.4103/jcecho.jcecho_91_24. Epub 2025 Jul 30.
Heart failure (HF) is a clinical syndrome that often leads to the complications such as pulmonary arterial hypertension (PAH), particularly Group 2 PAH secondary to left heart disease (PH-LHD). Echocardiography, a noninvasive tool, is used to assess the hemodynamic changes such as left ventricular ejection fraction (EF) and filling pressures. While most existing studies focused on PAH in HF with preserved EF, this study examines the incidence and hemodynamic impact of PAH in heart failure with reduced ejection fraction (HFrEF), addressing a critical gap in understanding.
A retrospective, analytical cohort study was conducted using the patient details retrieved from the electronic medical records of the HF clinic. Data were collected for the period between January 2018 and December 2021. The convenience sampling was used to identify the patients diagnosed with heart failure with reduced ejection fraction (HFrEF) and secondary PAH based on echocardiographic assessments.
Among the cohort, 54% of patients exhibited secondary PAH with HFrEF. The significant correlations were found between PAH and left ventricular (LV) hemodynamic changes, including reduced EF, elevated filling pressures, and valve regurgitations such as mitral, tricuspid, and pulmonic regurgitation.
Despite limitations described, this research demonstrates a robust association between PAH and LV dysfunction in HFrEF patients. The study's strengths include its adequate sample size and the application of validated echocardiographic methods to assess the hemodynamic changes.
心力衰竭（HF）是一种临床综合征，常导致诸如肺动脉高压（PAH）等并发症，尤其是继发于左心疾病的2型PAH（PH-LHD）。超声心动图作为一种非侵入性工具，用于评估血流动力学变化，如左心室射血分数（EF）和充盈压。虽然大多数现有研究聚焦于射血分数保留的心力衰竭中的PAH，但本研究调查了射血分数降低的心力衰竭（HFrEF）中PAH的发生率及其对血流动力学的影响，填补了认识上的一个关键空白。
采用回顾性分析队列研究，使用从心力衰竭门诊电子病历中检索到的患者详细信息。收集2018年1月至2021年12月期间的数据。采用便利抽样法，根据超声心动图评估确定诊断为射血分数降低的心力衰竭（HFrEF）和继发性PAH的患者。
在该队列中，54%的患者表现为HFrEF合并继发性PAH。发现PAH与左心室（LV）血流动力学变化之间存在显著相关性，包括EF降低、充盈压升高以及二尖瓣、三尖瓣和肺动脉瓣反流等瓣膜反流。
尽管存在所述局限性，但本研究表明PAH与HFrEF患者的左心室功能障碍之间存在密切关联。该研究的优势包括样本量充足以及应用经过验证的超声心动图方法评估血流动力学变化。
