Pulmonary Circulation and RV: Research Article

Lin Y. · Pang L. · Huang S. · Shen J. · Wu W. · Tang F. · Su W. · Zhu X. · Sun J. · Quan R. · Yang T. · Han H. · He J.

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Article / Publication Details Abstract

Introduction: Pulmonary hypertension due to left heart failure (PH-LHF) is a disease with high prevalence and 3-year mortality rates. Consequently, timely identification of patients with high mortality risk is critical. This study aimed to build a nomogram for predicting 3-year mortality and screening high-risk PH-LHF patients. Methods: This nomogram was developed on a training cohort of 175 patients with PH-LHF diagnosed by right heart catheterization (RHC). Multivariate Cox regression was used to identify independent predictors and develop this nomogram. The median total points obtained from the nomogram were used as a cut-off point, and patients were classified into low- and high-risk groups. The concordance index (C-index) and calibration curve were utilized to ascertain the predictive accuracy and discriminative ability of the nomogram. External validation was performed using a validation cohort of 77 PH-LHF patients from other centers. Results: Multivariate Cox regression showed that the New York Heart Association functional classification (NYHA FC), uric acid level, and mean pulmonary arterial pressure (mPAP) were all independent predictors and incorporated into the nomogram. The nomogram showed good discrimination (C-index of 0.756; 95% CI: 0.688 – 0.854), and good calibration. The Kaplan-Meier survival analysis showed that patients in the high-risk group had worse survival ( p

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