Dokumentenart: | Artikel | ||||
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Titel eines Journals oder einer Zeitschrift: | The Journal of Heart and Lung Transplantation | ||||
Verlag: | Elsevier | ||||
Ort der Veröffentlichung: | NEW YORK | ||||
Band: | 39 | ||||
Nummer des Zeitschriftenheftes oder des Kapitels: | 12 | ||||
Seitenbereich: | S. 1435-1444 | ||||
Datum: | 2020 | ||||
Institutionen: | Medizin > Lehrstuhl für Innere Medizin II | ||||
Identifikationsnummer: |
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Stichwörter / Keywords: | DIFFUSION CAPACITY; HEART-FAILURE; SURVIVAL; CAPILLARY; DIAGNOSIS; pulmonary arterial hypertension; phenotypes; cluster; survival; mortality | ||||
Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
Status: | Veröffentlicht | ||||
Begutachtet: | Ja, diese Version wurde begutachtet | ||||
An der Universität Regensburg entstanden: | Ja | ||||
Dokumenten-ID: | 49478 |
Zusammenfassung
The term idiopathic pulmonary arterial hypertension (IPAH) is used to categorize patients with capillary pulmonary hypertension of unknown origin. There is considerable variability in the clinical presentation of these patients. Using data from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension, we performed a cluster analysis of 841 patients with IPAH ...
Zusammenfassung
The term idiopathic pulmonary arterial hypertension (IPAH) is used to categorize patients with capillary pulmonary hypertension of unknown origin. There is considerable variability in the clinical presentation of these patients. Using data from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension, we performed a cluster analysis of 841 patients with IPAH based on age, sex, diffusion capacity of the lung for carbon monoxide (DLCO; <45% vs >= 45% predicted), smoking status, presence of comorbidities (obesity, hypertension, coronary heart disease, and diabetes mellitus). hierarchical agglomerative clustering algorithm was performed using Ward's minimum variance method. The clusters were analyzed in terms of baseline characteristics; survival; and response to monary arterial hypertension (PAH) therapy, expressed as changes from baseline to follow-up in functional class, 6-minute walking distance, cardiac biomarkers, and risk. Three clusters were identified: Cluster 1 (n = 106; 12.6%): median age 45 years, 76% females, comorbidities, mostly never smokers, DLCO >= 45%; Cluster 2 (n = 301; 35.8%): median age 75 years, 98% females, frequent comorbidities, no smoking history, DLCO mostly >= 45%; and Cluster (n = 434; 51.6%): median age 72 years, 72% males, frequent comorbidities, history of smoking, low DLCO. Patients in Cluster 1 had a better response to PAH treatment than patients in the 2 other clusters. Survival over 5 years was 84.6% in Cluster 1, 59.2% in Cluster 2, and 42.2% in Cluster (unadjusted p < 0.001 for comparison between all groups). The population of patients diagnosed with IPAH is heterogenous. This cluster analysis identified tinct phenotypes, which differed in clinical presentation, response to therapy, and survival. (C) 2020 The Author(s). Published by Elsevier Inc. on behalf of International Society for Heart and Lung Transplantation.
Metadaten zuletzt geändert: 11 Okt 2021 12:35