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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1526471
Impedance cardiography parameters reflecting left ventricular function are markers of pulmonary arterial hypertension
Provisionally accepted- 1Dongying People’s Hospital, Dongying, China
- 2Qilu Hospital of Shandong University, Jinan, Shandong, China
- 3Pingyin People's Hospital, Jinan, Shandong, China
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Background: Pre-capillary pulmonary hypertension (PH) is characterized by pulmonary vascular remodeling and right heart failure. We aim to identify impedance cardiography (ICG) parameters potential in pre-capillary PH screening and prognostic prediction.Methods: A discovery cohort consisting 26 pulmonary arterial hypertension (PAH) patients and 20 healthy volunteers was set from August 2018 to March 2019. Another 100 patients who had right heart catheterization (RHC) due to suspected PAH were enrolled from April 2019 to August 2020 as the validation cohort. Sixty-two pre-capillary PH patients involved in both discovery and validation cohorts were followed up for 41 months. Relationships between ICG parameters with pre-capillary PH screening and prognostic prediction were studied.Results: Pre-capillary PH patients exhibited lower left ventricular stroke work (LSW) and left ventricular stroke work index (LSWI) compared to health control, which is further proved in the validation cohort (51.5 (41.8-67.2) vs 69.7 (68.1-72.3) g·m/beat, p=0.014 for LSW; 30.9 (26.5-40.9) vs 41.7 (40.8-43.8) g·m/beat/m2, p=0.026 for LSWI). Patients in low risk status at baseline exhibited much higher LSW (57.1 (45.8, 73.1) vs 45.8 (35.1, 57.4) g·m/beat, p=0.002) and LSWI (35.1 (28.4, 43.7) vs 27.2 (20.4, 36.3) g·m/beat/m2, p<0.001) than those in intermediate/high risk. The cut-off points that predicted PAH low risk status was 57.85 g·m/beat (sensitivity 59% and specificity 63%) for LSW and was 36.75 g·m/beat/m2 (sensitivity 61% and specificity 79%) for LSWI. During follow-up, the hazard ratio (HR) for a clinical worsening event in the LSW < 58 g·m/beat group was 8.80 (95% confidence interval (CI) : 3.16 to 24.54; p=0.0001), this is the same in LSWI < 37 g·m/beat/m2 group (HR = 7.36, 95% CI: 2.65 to 20.44; p=0.0001).Conclusion: LSW and LSWI detected by ICG are useful in pre-capillary PH screening and valuable as long-term predictors of clinical worsening in pre-capillary PH treatment.
Keywords: pulmonary arterial hypertension, impedance cardiography, left ventricular stroke work, left ventricular stroke work index, prognosis
Received: 15 Nov 2024; Accepted: 15 Apr 2025.
Copyright: © 2025 Yang, Wang, Yang, Li and Cui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xin Li, Dongying People’s Hospital, Dongying, China
Xiaopei Cui, Qilu Hospital of Shandong University, Jinan, Shandong, China
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