Evaluating of Red Blood Cell Distribution Width, Comorbidities and Electrocardiographic Ratios as Predictors of Prognosis in Patients with Pulmonary Hypertension
Abstract
:1. Introduction
2. Materials and Methods
2.1. Electrocardiography
2.2. Echocardiography
2.3. Right Heart Catheterisation
2.4. Statistical Analysis
3. Results
3.1. Descriptive Analysis
3.2. Severity and Survival Analysis
3.3. Electrocardiographic Ratios
3.4. Multivariate Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Factor | Severity | Mortality | ||||
---|---|---|---|---|---|---|
Severe | Mild-Moderate | p | Deceased | Alive | p | |
Age (years) | 57.32 ± 12.70 | 57.01 ± 13.43 | 0.94 | 60.74 ± 15.77 | 53.95 ± 11.37 | 0.07 |
Weight (kg) | 64.13 ± 19.08 | 64.47 ± 13.97 | 0.56 | 63.12 ± 11.57 | 64.32 ± 14.86 | 0.97 |
Height (cm) | 155.48 ± 6.15 | 157.23 ± 9.73 | 0.47 | 156.78 ± 6.69 | 157.70 ± 9.69 | 0.98 |
Body mass index (kg/m2) | 26.52 ± 7.42 | 26.09 ± 5.29 | 0.88 | 25.70 ± 4.56 | 25.84 ± 5.38 | 0.88 |
Hospital stay (days) | 13.97 ± 5.46 | 16.84 ± 10.40 | 0.31 | 15.23 ± 7.73 | 14.32 ± 6.30 | 0.69 |
Duration of prior disease (years) | 38.67 ± 26.27 | 33.01 ± 33.99 | 0.09 | 25.71 ± 21.77 | 36.57 ± 30.19 | 0.19 |
Factor | Severity | Mortality |
---|---|---|
p | p | |
Age > 65 years | 0.59 | 0.02 |
Body mass index > 30 kg/m2 | 0.64 | 0.81 |
Male sex | 0.47 | 0.10 |
Intensive care unit requirement | 0.37 | 0.001 |
Comorbidities and Risk Factors | ||
Previous disease > 28 months | 0.000007 | 0.07 |
Autoimmune disease | 0.40 | 0.06 |
Bronchiolitis | 0.03 | 0.07 |
Collagenopathies | 0.03 | 0.56 |
Pulmonary fibrosis | 0.001 | 0.04 |
Systemic hypertension | 0.55 | 0.34 |
Smoking > 2 packs/year | 0.12 | 0.00009 |
Electrocardiogram | ||
Non-sinus rhythm | 0.78 | 0.002 |
Heart rate >100 bpm | 0.890 | 0.04 |
P-wave amplitude > 0.25 mV | 0.647 | 0.56 |
P-wave duration > 100 mS | 0.565 | 0.79 |
PR duration > 200 mS | 0.487 | 0.02 |
P°/T° ratio < 1 | 0.002 | 0.44 |
QRS°/T° ratio < −1.5 | 0.333 | 0.03 |
Echocardiogram | ||
Right atrium diameter > 44 mm | 0.00005 | 0.034 |
Pulmonary artery ring > 21 mm | 0.11 | 0.028 |
RV diastolic diameter > 28 mm | <0.000001 | 0.003 |
Spirometry | ||
Functional vital capacity < 69% | 0.03 | 0.52 |
Carbon monoxide diffusing capacity < 35% | 0.00008 | 0.01 |
6-min Walk | ||
Distance < 360 m | 0.42 | 0.01 |
Distance < 390 m | 0.17 | 0.04 |
Final SO2 > 69% | 0.00008 | 0.90 |
Radiographic and Tomographic Findings | ||
Ground-glass pattern | 0.03 | 0.48 |
Cardiomegaly III-IV | 0.22 | 0.30 |
Mediastinal enlargement | 0.005 | N/A |
Variable | Univariate Cox Model | Multivariate Cox Model (Quantitative Variables) | Multivariate Cox Model (Qualitative Variables) | ||||||
---|---|---|---|---|---|---|---|---|---|
p | HR | IC 95% | p | HR | 95% CI | p | HR | 95% CI | |
Age (years) | 0.576 | 1.010 | 0.975–1.047 | 0.268 | 1.025 | 0.981–1.071 | 0.325 | 1.023 | 0.977–1.071 |
Female sex | 0.486 | 0.763 | 0.357–1.632 | 0.01 | 0.215 | 0.07–0.64 | 0.005 | 0.176 | 0.052–0.596 |
Collagenopathies | 0.041 | 2.822 | 1.041–7.653 | 0.001 | 8.629 | 2.38–31.32 | 0.001 | 8.876 | 2.378–33.135 |
P°/T° ratio | 0.001 | 0.937 | 0.901–0.974 | 0.009 | 0.931 | 0.88–0.98 | – | – | – |
P°/T° ratio > 1 | 0.010 | 0.145 | 0.033–0.624 | – | – | – | 0.018 | 0.160 | 0.035–0.731 |
RDW% | 0.00002 | 1.399 | 1.198–1.633 | 0.017 | 1.247 | 1.04–1.49 | – | – | – |
RDW% > 18% | 0.0004 | 5.143 | 2.072–12.762 | – | – | – | 0.017 | 3.916 | 1.280–11.982 |
Variable | Univariate Cox-Model | Multivariate Cox Model (Quantitative Variables) | Multivariate Cox Model (Qualitative Variables) | ||||||
---|---|---|---|---|---|---|---|---|---|
p | HR | IC 95% | p | HR | 95% CI | p | HR | 95% CI | |
Age (years) | 0.04 | 1.042 | 1.001–1.085 | 0.006 | 1.57 | 1.04–1.28 | 0.01 | 1.11 | 1.02–1.20 |
Female sex | 0.11 | 2.00 | 0.85–4.72 | 0.38 | 0.57 | 0.16–1.97 | 0.41 | 1.68 | 0.47–5.98 |
QRS°/T° ratio | 0.002 | 1.10 | 1.03–1.18 | 0.000 | 1.21 | 1.09–1.34 | – | – | – |
QRS°/T° ratio > 0.3 | 0.31 | 1.61 | 0.63–4.09 | – | – | – | 0.03 | 3.76 | 1.15–12.73 |
FEV1 | 0.54 | 0.99 | 0.96–1.01 | 0.01 | 0.94 | 0.91–0.98 | 0.007 | 0.95 | 0.92–0.99 |
HTO | 0.74 | 0.99 | 0.93–1.04 | 0.04 | 0.93 | 0.87–0.99 | – | – | – |
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Baltazares-Lipp, M.E.; Aguilera-Velasco, A.; Aquino-Gálvez, A.; Velázquez-Cruz, R.; Hernández-Zenteno, R.J.; Alvarado-Vásquez, N.; Camarena, A.; Sierra-Vargas, M.P.; Chávez-Pacheco, J.L.; Ruiz, V.; et al. Evaluating of Red Blood Cell Distribution Width, Comorbidities and Electrocardiographic Ratios as Predictors of Prognosis in Patients with Pulmonary Hypertension. Diagnostics 2021, 11, 1297. https://doi.org/10.3390/diagnostics11071297
Baltazares-Lipp ME, Aguilera-Velasco A, Aquino-Gálvez A, Velázquez-Cruz R, Hernández-Zenteno RJ, Alvarado-Vásquez N, Camarena A, Sierra-Vargas MP, Chávez-Pacheco JL, Ruiz V, et al. Evaluating of Red Blood Cell Distribution Width, Comorbidities and Electrocardiographic Ratios as Predictors of Prognosis in Patients with Pulmonary Hypertension. Diagnostics. 2021; 11(7):1297. https://doi.org/10.3390/diagnostics11071297
Chicago/Turabian StyleBaltazares-Lipp, Mario E., Alberto Aguilera-Velasco, Arnoldo Aquino-Gálvez, Rafael Velázquez-Cruz, Rafael J. Hernández-Zenteno, Noé Alvarado-Vásquez, Angel Camarena, M. Patricia Sierra-Vargas, Juan L. Chávez-Pacheco, Víctor Ruiz, and et al. 2021. "Evaluating of Red Blood Cell Distribution Width, Comorbidities and Electrocardiographic Ratios as Predictors of Prognosis in Patients with Pulmonary Hypertension" Diagnostics 11, no. 7: 1297. https://doi.org/10.3390/diagnostics11071297