Objectives: To assess pulmonary artery systolic pressures (PASP), the association between clinical and echocardiographic variables and PASP and the impact of PASP on 5-year mortality in a community-dwelling population of the oldest old.
Background: Aging appears to be associated with increasing pulmonary artery pressure although mechanisms remain unclear. While in younger subjects pulmonary hypertension (PHT) has been associated with increased mortality, the impact of PHT on mortality in this very elderly population remains unclear.
Methods: Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed at home with standard measurements including measurement of tricuspid regurgitation (TR) velocity to assess RVSP (n = 300). Survival status at 5 year follow-up was assessed via the centralized population registry.
Results: Mean TV gradients in the study population as a whole were 30.5 ± 9.4 mmHg. A significant relationship was noted between RVSP and left atrial volume (r= 0.27, p < 0.0001), left ventricular mass index (r= 0.26, p < 0.0001) and E:e' (r= 0.19, p < 0.03). Of the 300 subjects, 71 (23.7%) had died at 5 year follow-up. TV gradients were significantly associated with mortality in both unadjusted (HR 1.036 95% CI 1.015-1.058; p < 0.007) and adjusted (HR 1.036 95% CI 1.012-1.061; p < 0.0029) models.
Conclusions: We demonstrate that RVSP is elevated and related to elevated LVM, LA volume and reduced diastolic function in the oldest old. Increasing RVSP is significantly associated with mortality in this population.
