Non-response to acute vasodilator challenge and prognosis in heart failure with pulmonary hypertension.

ABSTRACT Background An acute vasodilator challenge is recommended in patients with heart failure and pulmonary hypertension during heart transplant evaluation. The aim of the study was to assess which hemodynamic parameters are associated with non-responsiveness to the challenge. Methods and Results The study is a retrospective analysis of 402 heart failure patients with pulmonary hypertension who underwent right heart catheterization and a pulmonary vasodilator challenge. Among the 140 who fulfilled the transplant guidelines eligibility criteria for the vasodilator challenge, 38 were responders and 102 non-responders. At multivariable analysis, diastolic blood pressure (DBP) 5 WU and pulmonary artery compliance (PCa) Conclusions In patients with heart failure and pulmonary hypertension, low PCa, high PVR and low DBP predict the non-responsiveness to acute vasodilator challenge whilst a poor right ventricular function predicts a dismal prognosis.