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Congenital heart disease
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Hospitalisations for heart failure predict mortality in pulmonary hypertension related to congenital heart disease
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  • Published on: 27 February 2019
    Hospitalization for Heart Failure as a Promising Risk Stratification Tool for Pulmonary Hypertension Related to Congenital Heart Disease
    • Qi Jin, Cardiologist Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College
    • Other Contributors:
      • Qin Luo, Cardiologist
      • Zhihui Zhao, Cardiologist
      • Zhihong Liu, Cardiologist

    To the Editor, we read with great interest the article by Ntiloudi et al[1], describing hospitalization for heart failure (HF) as a powerful predictor of mortality among adults with pulmonary hypertension related to congenital heart disease (PH-ACHD). Although pulmonary arterial hypertension (PAH) targeted therapy has improved their survival, long-term complications such as HF hospitalization commonly occurred, and dismal prognosis with a mortality rate of 18.5% deeply broke our heart, thus requiring earlier diagnosis, risk stratification and therapeutic intervention.
    Hospitalization for HF, a sign of clinical worsening, is associated with poor outcomes and generally used as one of composite endpoints in PAH[2], Ntiloudi et al stated nearly one-quarter of patients were hospitalized for HF, and they encountered a ninefold increased mortality risk compared to those not-hospitalized, since NYHA functional class III/IV raised a tenfold risk of death, its combination with HF hospitalization may better predict outcomes. A previous study[3] reported 29% patients with idiopathic and associated PAH were hospitalized for acute right heart failure at least once during a 39.1-month follow up, and those with hospitalizations had worse NYHA functional class, inferior right ventricle function, lower six minute walk test (6MWT) distance and worse outcomes defined by death/transplant (67% vs 33%). These two findings indicated a potential role of HF hospitalization for identifying...

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    Conflict of Interest:
    None declared.