Researchers discovered a higher prevalence of conduction disease in patients with idiopathic pulmonary arterial hypertension (PAH) than in patients without PAH and published their results in the Journal of Heart and Lung Transplantation. They also found conduction disease to be independently associated with more severe right heart dilation, older age, and the male sex.

“We retrospectively analyzed the 12-lead [electrocardiograms] of patients attending Royal Papworth Hospital with idiopathic or hereditary PAH up to May 2021,” the authors said. “Conduction disease was seen in 37.1% of patients in the [idiopathic] PAH group compared to 10.8% of the comparator group.”

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In terms of functional impairments, the research team found that the presence of conduction disease was associated with reduced scores on the 6-Minute Walk Distance test and higher Cambridge Pulmonary Hypertension Outcome Review scores across the activity, symptom perception, and quality of life domains.

Mortality was also notably higher in patients with conduction disease, beginning to manifest approximately 10 years after PAH diagnosis. Furthermore, several patients with PAH developed conduction disease during the follow-up period of the study.

The authors also found that in addition to older age, male sex, and more severe right heart dilation, higher N-terminal prohormone of brain natriuretic peptide levels were independently associated with greater functional impairment.

They recommend a more detailed study of the underlying mechanisms of conduction disease in patients with PAH, as well as an assessment of whether treatment of conduction disease would result in improved prognoses and functional abilities.

Reference

Reddy SA, Nethercott SL, Teh W, et al. Prevalence and clinical significance of conduction disease in patients with idiopathic pulmonary arterial hypertension. J Heart Lung Transplant. Published online April 7, 2022. doi:10.1016/j.healun.2022.03.024