학술논문
Exercise capacity-hemodynamics mismatch in elderly patients with pulmonary hypertension: A nationwide multicenter study from Taiwan Society of Cardiology Pulmonary Hypertension Registry (TAIPANS)
Document Type
article
Author
Chang-Ying Chen; Wang Mei-Tzu; Shih-Hsien Sung; Yih-Jer Wu; Chih-Hsin Hsu; Wan-Jing Ho; Yen-Hung Lin; Wei-Shin Liu; Ju-Chi Liu; Yung-Ta Kao; Wen-Shiann Wu; Chun-Hsien Wu; Meng-Huan Lei; Yu-Wei Chen; Chien Chen-Yu; Yu-Wei Chiu; Zen-Kong Dai; Tsung-Hsien Lin; Lin Lin; Cheng-Chih Chung; Chang-Min Chung; Sung-Hao Huang; Chin-Chang Cheng; Yen-Wen Wu; Ting-Hsing Chao; Juey-Jen Hwang; Charles Jia-Yin Hou; Wei-Chun Huang
Source
Heliyon, Vol 10, Iss 6, Pp e27537- (2024)
Subject
Language
English
ISSN
2405-8440
Abstract
Background: Demographics of pulmonary hypertension (PH) has changed a lot over the past forty years. Several recent registries noted an increase in mean age of PH but only a few of them investigated the characteristics of elderly patients. Thus, we aimed to analyze the characteristics of PH in such a population in this study. Methods: This multicenter study enrolled patients diagnosed with PH in group 1, 3, 4, and 5 consecutively from January 1, 2019 to December 31, 2020. A total of 490 patients was included, and patients were divided into three groups by age (≤45 years, 45–65 years, and >65 years). Results: The mean age of PH patients diagnosed with PH was 55.3 ± 16.3 years of age. There was higher proportion of elderly patients classified as group 3 PH (≤45: 1.3, 45–65: 4.5, >65: 8.1 %; p = 0.0206) and group 4 PH (≤45: 8.4, 45–65: 14.5, >65: 31.6 %; p 65, mean difference, 77.8 m [95% confidence interval (CI), 2.1–153.6 m]), lower mean pulmonary arterial pressure (mPAP) (≤45 vs. >65, mean difference, 10.8 mmHg [95% CI, 6.37–15.2 mmHg]), and higher pulmonary arterial wedge pressure (PAWP) (≤45 vs. 45–65, mean difference, −2.1 mmHg [95% CI, −3.9 to −0.3 mmHg]) compared to young patients. Elderly patients had a poorer exercise capacity despite lower mPAP level compared to young population, but they received combination therapy less frequently compared to young patients (triple therapy in group 1 PH, ≤45: 16.7, 45–65: 11.3, >65: 3.8 %; p = 0.0005). Age older than 65 years was an independent predictor of high mortality for PH patients. Conclusions: Elderly PH patients possess unique hemodynamic profiles and epidemiologic patterns. They had higher PAWP, lower mPAP, and received combination therapy less frequently. Moreover, ageing is a predictor of high mortality for PH patients. Exercise capacity-hemodynamics mismatch and inadequate treatment are noteworthy in the approach of elderly population with PH.