Echocardiographic Insights into Group 2 Pulmonary Hypertension: Unveiling its Prevalence in Advanced Heart Failure Reduced Ejection Fraction.

Abstract

Background: Heart failure (HF) is a clinical syndrome that often leads to the complications such as pulmonary arterial hypertension (PAH), particularly Group 2 PAH secondary to left heart disease (PH-LHD). Echocardiography, a noninvasive tool, is used to assess the hemodynamic changes such as left ventricular ejection fraction (EF) and filling pressures. While most existing studies focused on PAH in HF with preserved EF, this study examines the incidence and hemodynamic impact of PAH in heart failure with reduced ejection fraction (HFrEF), addressing a critical gap in understanding.

Methodology: A retrospective, analytical cohort study was conducted using the patient details retrieved from the electronic medical records of the HF clinic. Data were collected for the period between January 2018 and December 2021. The convenience sampling was used to identify the patients diagnosed with heart failure with reduced ejection fraction (HFrEF) and secondary PAH based on echocardiographic assessments.

Results: Among the cohort, 54% of patients exhibited secondary PAH with HFrEF. The significant correlations were found between PAH and left ventricular (LV) hemodynamic changes, including reduced EF, elevated filling pressures, and valve regurgitations such as mitral, tricuspid, and pulmonic regurgitation.

Conclusion: Despite limitations described, this research demonstrates a robust association between PAH and LV dysfunction in HFrEF patients. The study's strengths include its adequate sample size and the application of validated echocardiographic methods to assess the hemodynamic changes.