French National observatory on pulmonary hypertension measured by right heart catheterism in heart failure. First report of PHHF observatory. A study from GICC

Background The physiopathology, prevalence, characteristics and prognostic impact of the different type of pulmonary hypertension (PH) in CHF are unknown. The gold standard to measure PH is the right heart catheterism. Echocardiography allows just an estimate of pulmonary artery pressure. The main objective of PHHF is to compare the mortality between CHF patients with reactive and passive PH in CHF determined by right heart catheterization. The secondary objectives are to study the prevalence of the two types of PH, to identify their clinical, biological, cardiac and pulmonary determinants. Methods PHHF is a prospective, multicenter, observational, open-lapel observatory of CHF patients. The target population constituted of CHF patients necessitating right heart catheterization for their medical care. Five hundred patients with PH and HF and 120 HF without PH will be included before the 31st of December 2017. The primary endpoint will be death and/or urgent heart transplant and/or urgent ventricular assist device implant. The secondary endpoints will be hospitalizations for acute heart failure. The inclusion criteria are: (1) patients with CHF (LV systolic dysfunction, HFPEF, cardiac valvular disease) having a right heart catheterism; (2) written informed consent; (3) age ≥ 18 years; (4) optimal medical CHF treatment. Results The baseline characteristics of the patients (March 2017) are showed here. Five hundred and twenty-one patients are included of who 414 are in PH groups. Sixty-one percent are men. The mean (sd) age is 62 ± 13%. Fifty percent have LV systolic failure, 43% preserved LV ejection fraction and 6.5% valvular heart failure. Thirty-eight percent have a ischemic cardiopathy. Forty-three percent are in NYHA class II and 46% in III. The average of the mean pulmonary artery pressure (mPAP) was 35 ± 12 mmHg. The mean PCWP was 22 ± 7 mmHg. Conclusion Pulmonary artery pressure is severe and frequent in the three type of HF. More analysis will be provided at the end of the study (December 2017) for the JESFC Congress.