• Jacqueline T DesJardin, Nicholas A Kolaitis, Noah Kime, Richard A Kronmal, Raymond L Benza, Jean M Elwing, Matthew R Lammi, John W McConnell, Kenneth W Presberg, Jeffrey S Sager, Oksana A Shlobin, Teresa De Marco, and PHAR Investigators.
• Department of Medicine, University of California, San Francisco, San Francisco, California. Electronic address: jacqueline.desjardin@ucsf.edu.
• J. Heart Lung Transplant. 2020 Sep 1; 39 (9): 945-953.

BackgroundThe age of patients with pulmonary arterial hypertension (PAH) has increased, with registries now reporting mean ages of 50 to 65 years old. Limited data exist on age-related differences in hemodynamic and functional assessments in PAH.MethodsAdults with PAH in the Pulmonary Hypertension Association Registry were divided into 3 groups (18-50, 51-65, and >65 years old). Analysis of variance and chi-square testing were used to assess for baseline differences. Linear regression was used to examine the association of age with continuous hemodynamic and functional variables.ResultsA total of 769 patients with mean age of 56 ± 16 years were included. Older patients had more connective tissue disease-associated PAH and less drug-associated PAH. In linear regression models, each year of increased age was associated with shorter 6-minute walk distance (-3.37 meters; 95% CI, -3.97 to -2.76), lower mean pulmonary arterial pressure (-0.21 mm Hg; 95% CI, -0.27 to -0.15), and lower pulmonary vascular resistance (-0.06 Wood units; 95% CI, -0.09 to -0.04). Pulmonary arterial compliance, cardiac index, right ventricular stroke work index, and percent predicted 6-minute walk distance were unrelated to age; resistance-compliance time was negatively related to age (-3 milliseconds per year; 95% CI, -4 to -2).ConclusionsRelative to their pulmonary vascular resistance, older patients have lower pulmonary artery compliance and worse right ventricular performance. Based on these findings, we suspect that age influences right ventricular loading conditions and the response of the right ventricle to increased afterload.Published by Elsevier Inc.

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