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Research Article
Keiko Yamamoto
Chiba University
Corresponding Author
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Background: The 6th World Symposium on Pulmonary Hypertension (Nice 2018) proposed a new definition of pre-capillary pulmonary hypertension (PH) as a condition with mean pulmonary artery pressure (mPAP) > 20 mmHg, pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) ≥ 3 Wood units (WU). The characteristics and prognosis of patients with pre-capillary PH, according to this new definition, is unclear. Therefore, we determined the characteristics of patients with pre-capillary PH who had pulmonary vascular disease with slight elevation in mPAP.
Methods: We retrospectively enrolled 683 patients who underwent their first right heart catheterization (RHC) at Chiba University, Japan. Among them, 489 patients met the pre-capillary PH requirement with mPAP ≥ 25 mmHg (conventional pre-capillary PH group), while 22 patients met the borderline pre-capillary PH criteria (borderline pre-capillary PH group).
Results: The borderline pre-capillary PH group comprised 4.3% of the total pre-capillary PH patients, and the majority was in Group 3 (40.9%) or 4 (45.5%). The survival of the borderline pre-capillary PH group tended to be better than that of the conventional pre-capillary PH group.
Conclusions: Pre-capillary PH patients, according to the Nice 2018 definition, comprised 4.3 % of the population with total pre-capillary PH and had better survival than the conventional PH pre-capillary group; moreover, the majority of the pre-capillary PH cases were either Group 3 and 4.
Keywords
pulmonary arterial hypertension, World Symposium on Pulmonary Hypertension (WSPH) 2018, pulmonary artery wedge pressure, pulmonary vascular resistance
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No competing interests reported.
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CURRENT STATUS: Under Review
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Review #2 received
Received 06 Apr, 2021
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Received 23 Mar, 2021
Review #1 received
Received 23 Mar, 2021
Review #6 received
Received 23 Mar, 2021
Review #8 received
Received 23 Mar, 2021
Reviewer #7 agreed
On 14 Mar, 2021
Reviewer #9 agreed
On 12 Mar, 2021
Reviewer #3 agreed
On 12 Mar, 2021
Reviewer #2 agreed
On 12 Mar, 2021
Reviewer #8 agreed
On 12 Mar, 2021
Reviewer #10 agreed
On 12 Mar, 2021
Reviewer #1 agreed
On 12 Mar, 2021
Reviewers invited
Invitations sent on 11 Mar, 2021
Editor assigned
On 11 Mar, 2021
Editor invited
On 11 Mar, 2021
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On 11 Mar, 2021
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This preprint is under consideration at BMC Pulmonary Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Keiko Yamamoto
Chiba University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 Mar, 2021
No community comments so far
Review #2 received
Received 06 Apr, 2021
Review #7 received
Received 23 Mar, 2021
Review #1 received
Received 23 Mar, 2021
Review #6 received
Received 23 Mar, 2021
Review #8 received
Received 23 Mar, 2021
Reviewer #7 agreed
On 14 Mar, 2021
Reviewer #9 agreed
On 12 Mar, 2021
Reviewer #3 agreed
On 12 Mar, 2021
Reviewer #2 agreed
On 12 Mar, 2021
Reviewer #8 agreed
On 12 Mar, 2021
Reviewer #10 agreed
On 12 Mar, 2021
Reviewer #1 agreed
On 12 Mar, 2021
Reviewers invited
Invitations sent on 11 Mar, 2021
Editor assigned
On 11 Mar, 2021
Editor invited
On 11 Mar, 2021
Submission checks complete
On 11 Mar, 2021
First submitted
On 03 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The 6th World Symposium on Pulmonary Hypertension (Nice 2018) proposed a new definition of pre-capillary pulmonary hypertension (PH) as a condition with mean pulmonary artery pressure (mPAP) > 20 mmHg, pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) ≥ 3 Wood units (WU). The characteristics and prognosis of patients with pre-capillary PH, according to this new definition, is unclear. Therefore, we determined the characteristics of patients with pre-capillary PH who had pulmonary vascular disease with slight elevation in mPAP.
Methods: We retrospectively enrolled 683 patients who underwent their first right heart catheterization (RHC) at Chiba University, Japan. Among them, 489 patients met the pre-capillary PH requirement with mPAP ≥ 25 mmHg (conventional pre-capillary PH group), while 22 patients met the borderline pre-capillary PH criteria (borderline pre-capillary PH group).
Results: The borderline pre-capillary PH group comprised 4.3% of the total pre-capillary PH patients, and the majority was in Group 3 (40.9%) or 4 (45.5%). The survival of the borderline pre-capillary PH group tended to be better than that of the conventional pre-capillary PH group.
Conclusions: Pre-capillary PH patients, according to the Nice 2018 definition, comprised 4.3 % of the population with total pre-capillary PH and had better survival than the conventional PH pre-capillary group; moreover, the majority of the pre-capillary PH cases were either Group 3 and 4.
Figure 1
Figure 2
Figure 3
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