AIM To investigate the relationship between the parameters related to left heart function measured by echocardiography and the prognosis of patients with severe pulmonary hypertension (PAH).

METHODS Out of 55 patients, 20 experienced clinical deterioration events, of which 2 (4%) experienced all cause death, 10 (18%) were readmitted due to PAH deterioration, and 8 (14%) were upgraded to treatment. Compared with the group without clinical deterioration, the right ventricular/left ventricular diameter ratio, right ventricular diameter, and LVEF in the clinical deterioration group were larger (all P<0.01), stroke volume index and left ventricular end diastolic diameter were smaller (all P<0.05), and serum total bilirubin (P<0.05) and NT ProBNP were higher (all P<0.01). Multivariate Cox risk regression analysis showed that LVEF HR 1.66 (1.29～2.14); P<0.01) and NT ProBNP HR 1.001 (1.000～1.002); P<0.05 are independent predictors of prognosis in patients with severe PAH. The working characteristic curve of the subjects shows that LVEF 71% and NT ProBNP 724.5 pg/ml are the optimal cutoff values, with high sensitivity and specificity. Kaplan Meier survival analysis showed a significant increase in the incidence of clinical deterioration in patients with LVEF>71% and NT ProBNP>724.5 pg/ml (both P<0.01).

CONCLUSION Echocardiographic measurement of LVEF and NT-ProBNP well predict the incidence of clinical deterioration in patients with severe PAH.