Chest
Original ResearchPulmonary HypertensionAssociation of the Metabolic Syndrome With Pulmonary Venous Hypertension
Section snippets
Study Patients
This study was approved by the institutional review board at Vanderbilt Medical Center. We evaluated 122 consecutive new patients at the Vanderbilt Pulmonary Vascular Center between September 2004 and December 2005. No patient with more than mild impairment of LV systolic function, assessed by echocardiogram, was included in this cohort. All patients were evaluated using published guidelines to determine the presence, severity, and etiology of PH.15 Right heart catheterization (RHC) was
Results
The most common final diagnosis was PAH in 39 patients (32% of the total cohort) [Fig 1]. This group included idiopathic PAH in 14 patients (11% of the total cohort), PAH associated with connective tissue disease in 11 patients, congenital heart disease in 9 patients, portal hypertension in 3 patients, and HIV infection in 2 patients. The second most common diagnosis was PVH in 28 patients (23% of the total cohort), which included 6 patients with left-sided valvular disease. Excluding patients
Discussion
Our results reveal that PVH due to LV DD was a frequent cause of PH evaluated at a larger referral center and that > 90% of these patients have multiple features of the MS. PVH is often misdiagnosed in such patients as PAH, which is an important distinction for clinical decision making, especially because of the costs and potential toxicities of PAH therapies.18
The prevalence and severity of left-sided heart dysfunction with preserved ejection fraction has not been well quantified in cohorts of
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This study was supported by the following National Institutes of Health grants: NHLBI PO1 072058, NRSA F32 HL082132–02, and GCRC MO1 RR 00095.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).