Plasma Metabolomic Profiles Differentiate Hemodynamic Subtypes of Pulmonary Hypertension

Introduction: Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressures (mPAP) ≥ 25 mmHg. Within PH, there are distinct hemodynamic subgroups based on the presence of hypertension in the precapillary or postcapillary beds of the pulmonary vasculature: pulmonary arterial hypertension (PAH - precapillary PH), passive PH secondary to left heart disease (postcapillary PH) and mixed PH with both precapillary and postcapillary components. Hypothesis: As metabolic abnormalities have been noted in PAH and heart failure, we hypothesized that different hemodynamic subtypes of PH would be associated with distinct plasma metabolomic profiles. Methods: The CATHGEN biorepository consists of biological samples collected on over 9000 individuals undergoing cardiac catheterization at Duke University Medical Center. Of those subjects who had targeted metabolomics studies performed, 282 were identified with mPAP ≥ 25 mmHg. Of these 282 subjects, 133 met criteria for passive PH (PCWP u003e 15 mmHg, PVR 15 mmHg,...