This meta-registry analysis (PVRI GoDeep) evaluated whether pulmonary artery compliance (PAC), arterial elastance (Ea), and stroke volume index (SVI) predict mortality independently of PVR in patients with mild PH (mPAP 20–25 mmHg; n=1,097) and across the full PH spectrum (n=16,899, groups 1–5).
In mild PH, neither mPAP nor PVR predicted mortality (both p>0.05), but Ea, PAC, SVI, and heart rate each showed independent prognostic value. These findings held across 16,899 patients spanning all PH groups, independent of PVR/TPR and after multivariable adjustment.
- Registry-based design introduces selection bias and limits causal inference. - PAC and Ea are derived hemodynamic parameters; measurement consistency across contributing centers is uncertain. - Mild PH subgroup (n=1,097) is a minority of the full cohort, and confounders specific to this early-stage group may be incompletely captured.
In patients with mild PH, standard metrics like mPAP and PVR may miss important prognostic signals — consider also measuring PAC, Ea, and SVI at right heart catheterization to better stratify mortality risk. These pulsatile load parameters add prognostic value across all PH severity stages.
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