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Parker Lavigne, MD
Dr. Parker Lavigne
HonorHealth, United States
Disclosure information not submitted.
Elnaz Mahbub, DO,
Resident Physician
Stony Brook Southampton Hospital
Southampton, NY
Disclosure information not submitted.
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 Secondary Pulmonary Arterial Hypertension Causes
Introduction: Pulmonary hypertension (PH) is a complex and heterogeneous condition. Based on underlying etiology, the World Health Organization (WHO) established a classification schema of 5 groups to better understand and treat underlying pathology. Group 1 PH is subdivided into primary PAH and secondary PAH. While many secondary etiologies are well known, a paucity of data exists evaluating the cardiovascular risk of individual causes. At our teaching institution, we sought to evaluate the correlation between secondary PAH 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 Secondary PAH (WHO Group 1). A propensity matched regression analysis was performed controlling for age, gender, and comorbidities. Propensity weighted cohorts were compared for correlation between etiologies of secondary PAH (appetite suppressant adverse outcome, HIV, congenital heart disease, polymyositis, schistosomiasis, portal hypertension, RA, Sjogren's syndrome, and systemic sclerosis) with dysrhythmias including: 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 2,058 hospitalizations were evaluated, made up of a composite of patients with WHO Group 1 secondary pulmonary arterial hypertension. Population average age was 65.55+ 0.81 years, 62.05% of whom were female. A propensity matched 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). Congenital heart disease was associated with VT. Portal hypertension was strongly associated with all dysrhythmia except VT. Systemic sclerosis was strongly associated with all dysrhythmia except AF/AFL and VT.
Conclusions: Better defined subpopulation risk of developing dysrhythmia in secondary pulmonary arterial hypertension may help identify etiology of outcome variation. This may ultimately allow for early intervention in at-risk groups.