The only clinical diagnostic and prognostic biomarker for measuring afterload on the right ventricle caused by Pulmonary Arterial Hypertension is Pulmonary Vascular Resistance (PVR). However, recent studies have shown that Pulmonary Vascular Compliance (PVC) is a better prognostic biomarker than PVR, and PVR and PVC are coupled. Thus, measuring and treating PVR will naturally restore PVC. However, there is current debate whether if coupling is occurring. To determine if coupling between PVR and PVC is taking place 324 patients underwent routine right heart catherization for hemodynamics data collection. The data was stored in REDCap database that was used to calculated PVR, PVC, and time constant. The data was transformed using natural logarithmic function, and feed into statistical analyses that generated check for parametric conditions, linear models, ANCOVA tests, and 95% confidence intervals. In addition, difference plot was created between therapeutic trial and normal condition. The ANCOVA tests of linear models found that PVR and PVC are uncoupled between controls, idiopathic pulmonary hypertension, associated pulmonary hypertension, and therapeutic trials with P-values less than .05. In addition, the 95% confidence intervals revealed that between therapeutic challenges PVR and PVC are uncoupled, however, between controls and non-controls PVR and PVC are coupled. The different plot displayed that patient data existed in both the coupled quadrants and uncoupled quadrants. The ANCOVA results are critical because they display that PVR and PVR are uncoupled and both need to be measured and treated. However, the results from the 95% confidence interval display that PVR and PVC are coupled. The difference in results is solved with the difference plot revealing that there is both coupling and uncoupling between PVR and PVC. This means that there are different levels of coupling between PVR and PVC for different severities of PH. Thus, time constant could be used a predictor of PH severity and life expectancy.
|Commitee:||Lanning, Craig, Truong, Uyen|
|School:||University of Colorado at Denver|
|School Location:||United States -- Colorado|
|Source:||MAI 56/05M(E), Masters Abstracts International|
|Subjects:||Mathematics, Biomedical engineering, Medicine|
|Keywords:||Bioengineering, Cardiology, Pedatrics, Pulmonary hypertension|
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