The high prevalence of pulmonary hypertension (PH) in elderly patients is well known. However, much remains unknown about those population. We sought to find the clinical characteristics of echocardiographic PH and the prognostic factors in patients ≥90 years of age. We retrospectively reviewed 310 patients ≥90 years of age (median age 92 years, 64% women) diagnosed as echocardiographic PH (peak systolic pulmonary arterial pressure ≥40 mm Hg) with normal left ventricular systolic function. We defined left heart disease (LHD) as significant left-sided valve diseases, left ventricular hypertrophy and left ventricular diastolic dysfunction by using echocardiography. The endpoint was all-cause death at 2,000 days after diagnosis. LHD was found in 92% of patients. During the median follow-up of 367 days (interquartile range, 39-1,028 days), 151 all-cause deaths (49%) occurred. Multivariable Cox regression analysis demonstrated that right ventricular fraction area change <35% (adjusted hazard ratio [HR]: 2.31; p <0.001), pericardial effusion (adjusted HR: 2.28; p <0.001), serum albumin <3.5 g/dL (adjusted HR: 1.76; p = 0.001), chronic obstructive pulmonary disease (adjusted HR: 1.93; p = 0.001) and New York Heart Association (NYHA) class ≥II (adjusted HR: 1.73; p = 0.004) were associated with mortality after adjusted for age. In conclusion, LHD was significantly associated with echocardiographic PH in most patients ≥90 years of age. Also, the co-morbid factors at diagnosis (right ventricular systolic dysfunction, pericardial effusion, hypoalbuminemia, chronic obstructive pulmonary disease, and NYHA class ≥II) were independently associated with mortality.

老年患者的肺动脉高压（PH）患病率很高。然而，关于这些人口的许多事情仍然未知。我们试图找到≥90岁患者的超声心动图PH的临床特征和预后因素。我们回顾性分析了310例≥90岁（中位年龄92岁，64％的女性）的患者，这些患者被诊断为超声心动图PH（峰值收缩期肺动脉压≥40 mm Hg）且左心室收缩功能正常。通过使用超声心动图，我们将左心疾病（LHD）定义为严重的左侧瓣膜疾病，左心室肥大和左心室舒张功能障碍。终点是诊断后2,000天的全因死亡。在92％的患者中发现了LHD。在367天的中位随访期间（四分位间距为39-1,028天），发生了151起全因死亡（49％）。多变量Cox回归分析显示右心室面积变化<35％（危险比调整后[HR]：2.31; p <0.001），心包积液（HR调整后：2.28; p <0.001），血清白蛋白<3.5 g / dL（校正后的HR：1.76； p = 0.001），慢性阻塞性肺疾病（校正后的HR：1.93； p = 0.001）和纽约心脏协会（NYHA）≥II级（校正后的HR：1.73； p = 0.004）与死亡率相关。根据年龄调整。总之，在大多数≥90岁的患者中，LHD与超声心动图PH显着相关。另外，诊断时的合并症因素（右心室收缩功能障碍，心包积液，低白蛋白血症，慢性阻塞性肺疾病和NYHA≥II级）与死亡率独立相关。