We are delighted to share that Professor Geoff Strange, lead author and co-principal investigator of NEDA (the National Echo Database of Australia), had his most recent Pulmonary Hypertension publication found in June 2019’s Volume 73 of JACC (Journal of the American College of Cardiology).
The paper, ‘Thresholds of Pulmonary Hypertension Associated with Increased Mortality‘, was the subject of JACC Editorial Comment and we are pleased to share with you a couple of excerpts:
Toward Early Diagnosis of Pulmonary Hypertension - Lessons from OZ
In this issue of the Journal, Strange et al. assembled a remarkable database of approximately 157,800 individual patient echocardiograms over a 20-year period from an Australian national cohort. The data were linked to hard clinical endpoints, and the population size permitted an analysis of eRVSP risk not contingent on pre-specified values, which, in turn, provided novel information on the association between mortality and mildly elevated PA pressure when measured noninvasively. The investigators specifically showed that adjusted risk for all-cause and cardiovascular-associated mortality increased significantly by 41% and 35%, respectively, beginning at an eRVSP of approximately 30 mm Hg (corresponding to mPAP of w20 mm Hg [14]). Directionally similar findings for the adjusted hazard for all-cause mortality were observed even after accounting for the confounding influence of age or the presence and/or absence of echocardiographically defined left heart disease. Furthermore, mild PH was common and observed in 29% of patients, which provided contemporary insight into the epidemiology and extent of this clinical problem.
Strange et al. provide compelling evidence from a large national database in Australia on the continuum of risk relative to PA pressure when measured noninvasively. They observed that mild PH, defined by an eRVSP of approximately 30 mm Hg, was common and associated with substantial clinical hazard. This study opens a path toward diagnosing PH earlier in the community, emphasizes the need to understand better RV function in mild PH, and moves the field one step closer to an era of preventative medicine. Completing clinical studies that inform practitioners on the trajectory of patients with mild PH suggested by echocardiography, particularly recommendations on specialty referral and effective risk modification strategies, is a natural next phase in this exciting time for pulmonary vascular medicine.
You can read the Pulmonary Hypertension Publication full paper by downloading the PDF document below: