Elnaz Mahbub, DO,
Resident Physician
Stony Brook Southampton Hospital
Southampton, NY
Disclosure information not submitted.
Parker Lavigne, MD
Dr. Parker Lavigne
HonorHealth, United States
Disclosure information not submitted.
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Garry Lachhar, MD
Resident Physician
Stony Brook Southampton Hospital
Southampton, NY
Disclosure information not submitted.
Krishna Akella, DO
Dr. Krishna Akella
HonorHealth, United States
Disclosure information not submitted.
Therese Sargent, NP
Therese Sargent, NP
HonorHealth, United States
Disclosure information not submitted.
Title: Dysrhythmia Correlation in Pulmonary Hypertension by WHO Classification
Introduction: Pulmonary hypertension (PH) is a complex and multifactorial condition. Obtaining a better understanding of a patient’s cardiovascular risk and outcome profile is predicated on determination of homogenous subcategories. Specific definitions established based on the World Health Organization (WHO) classification system subcategorize PH based on etiology. At our teaching institution, we sought to evaluate the correlation between PH and dysrhythmia.
Methods: A composite database of National Inpatient Sample (NIS) for 2016 and 2017 was queried using ICD-10 codes to identify patients with PH subdivided based on WHO classification. Group 1 PH (PAH) was further subcategorized into primary and secondary. A propensity weighted logistic regression analysis was performed controlling for age, gender, and comorbidities. Propensity weighted cohorts were compared for correlation with dysrhythmias [atrial fibrillation/flutter (AF/AFL), sick sinus syndrome (SSS), bradyarrhythmia, AV block (AVB1, AVB2, CHB), supraventricular tachycardia (SVT), ventricular tachycardia (VT), and ventricular fibrillation (VF)].
Results: A study cohort with 56,208 hospitalizations were evaluated, made up of a composite of patients with pulmonary hypertension. Population average age was 70.10+ 0.13 years, 59.12% of whom were female. A propensity weighted logistic regression model using each dysrhythmia category as a dependent variable was performed using Stata 17.0 controlling for age, gender, and comorbidity (presence of AICD, Pacemaker, history of chronic heart failure, diabetes, ischemic stroke, COPD, PVD, CKD, OSA, hypertension, CAD). Using a Bonferroni correction for 15 variables, a p value threshold of 0.003 was used. All dysrhythmias were found to be strongly associated with WHO Group 2 PH. All dysrhythmias except VT were strongly associated with WHO Group 3. Group 5 PH was associated with SSS, AVB2, CHB and SVT (Table 1).
Conclusion: Patients with PH have variability in arrhythmogenic propensity. Better defined risk factors may assist in early identification of comorbidity and potential intervention in at-risk subpopulations.