We hypothesized that the RAP/PAWP ratio may be used as predictor of survival in patients with PAH and that it is more predictive of survival than other hemodynamic variables. In patients with right heart failure, the ratio of right atrial pressure (RAP) and pulmonary artery wedge pressure (PAWP) is raised. Traditionally, the RAP value has been used as a marker of right heart dysfunction. Thus, right ventricular function is one of the prognostic factors of PAH. With disease progression, the increased pulmonary vascular resistance to blood flow leads to increased right atrial pressure (RAP) and right heart failure. The underlying cause of PAH is believed to be inflammatory and autoimmune in nature.
The condition is also characterized by obstruction of pulmonary vasculature and elevated pulmonary arterial pressure due to vasoconstriction, hyperplasia and hypertrophy of all three layers (intima, media and adventitia) of the small pulmonary arteries. Vascular remodeling and formation of complex vascular lesions are the hallmarks of PAH. The condition is more common in women than men with a mean age at time of presentation ranging between 45 and 65 years in western registries. Common symptoms of PAH include shortness of breath, exertional syncope and reduced exercise capacity. Pulmonary arterial hypertension (PAH) is a progressive, incurable condition with poor prognosis and high rates of mortality. We do not endorse non-Cleveland Clinic products or services Policy Advertising on our site helps support our mission. Cleveland Clinic is a non-profit academic medical center.
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