ヤマグチ　ジユンイチ   YAMAGUCHI Jiyun'ichi   山口　淳一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
言語種別	日本語
発表タイトル	Pulmonary Hypertension in Patients with Hemodialysis: Epidemiology and Clinical Impact
会議名	第79回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎吉田彩乃, 芹澤直紀, 椙山恒, 加藤好信, 鈴木豪, 山口淳一, 志賀剛, 萩原誠久
発表年月日	2015/04/26
開催地 （都市, 国名）	大阪市
学会抄録	PROGRAM JCS 2015 768
概要	Background: Previous paper reported that pulmonary hypertension (PH) was common and a predictor of mortality in patients with hemodialysis. However, there was no large-scale study evaluating by using right heart catheterization(RHC). Methods: We enrolled patients with hemodialysis who underwent elective RHC retrospectively. PH was defined as mean pulmonary arterial pressure>25 mmHg; Precapillary PH(group 5) was defined as pulmonary arterial wedge pressure<15 mmHg. We assessed the prevalence of group 5 and postcapillary PH(group 2) and the prognostic impact of PH in patients with hemodialysis.Results: Nine hundred thirty eight patients were examined. During averaged 3.6 years follow-up, 166 patients died. Two hundred thirty nine out of 938 patients(25%) had PH. The prevalence of group 5 was 51(5%) and group 2 was 188 patients(20%). LVEF was significant differences among the group (no-PH: 48±1%, group 5: 41±2%, and group 2: 40±1%, p for trend<0.001, respectively). Survival rate was significantly lower in patients with PH than those without(HR 2.16, 95%CI: 1.55-2.97, p<0.001). On multivariate analysis, group 2 was a significant factor on mortality after adjusting for confounding factors such as LVEF and age(HR 2.09, 95%CI 1.43-3.00, p<0.001) but not group 5. Conclusions: Present study suggested that PH is common, and group 2 PH was a significant predictor of mortality in hemodialysis patients, but not group 5.