Arterial partial pressure of oxygen and procalcitonin levels correlate with pulmonary artery systolic pressure in patients with active pulmonary tuberculosis

Li Wen-Ting,Wu Chang-Wei,Bian De-Jian,Sha Wei

doi:10.1016/j.ijid.2022.01.060

Abstract

ObjectWe aimed to study whether arterial blood gas parameters, inflammatory markers, and coagulation indicators correlate with pulmonary artery systolic pressure (PASP) values in patients with active pulmonary tuberculosis (PTB). MethodsA total of 121 patients with PTB who had a measurement of PASP by Doppler echocardiography in the active phase of tuberculosis were included in this study. We carried out univariate and multivariate linear regression analyses to determine factors correlated with PASP values. We excluded patients with other diseases or conditions that might lead to increased PASP. ResultsUnivariate linear regression analysis revealed positive correlations of age, white blood cell count, neutrophils ratio, Log procalcitonin, erythrocyte sedimentation rate, Log C-reactive protein, fibrinogen, Log D-dimer with PASP and showed an inverse correlation of arterial partial pressure of oxygen (PaO2) and arterial oxygen saturation (SaO2) with PASP. Multiple linear regression analysis demonstrated that PaO2 and Log procalcitonin remained correlated with PASP values. ConclusionPaO2 and procalcitonin were strongly correlated with PASP values in patients with active PTB. The degree of hypoxia and severity of secondary respiratory bacterial infection may influence PASP value in active PTB.

Highlights

Pulmonary tuberculosis (PTB) is a health problem worldwide
Object: We aimed to study whether arterial blood gas parameters, inflammatory markers, coagulation indicators have correlation with pulmonary artery systolic pressure (PASP) values in patients with active pulmonary tuberculosis (PTB)
We retrospectively studied a cohort of PTB patients who had measurement of pulmonary artery systolic pressure (PASP) by Doppler echocardiography in the active phase of tuberculosis, sought to investigate whether inflammatory markers, coagulation indicators, arterial blood gas parameters have correlation with the PASP values

Summary

Introduction

Pulmonary tuberculosis (PTB) is a health problem worldwide. Pulmonary lesions and parenchymal destruction caused by tuberculosis may lead to abnormal pulmonary hemodynamics and increased pulmonary vascular resistance, triggering pulmonary hypertension (PH). PH due to lung diseases and/or hypoxemia is classified as group 3 (Mandras et al, 2020). Early detection of elevated pulmonary artery pressure in active phase of PTB and intervention of correlated factors may help to improve treatment outcome for PTB patients. Previous studies have pointed that hypoxic vasoconstriction, hypoxic vascular remodeling, inflammatory cytokines, clotting system activation contribute to increased pulmonary vascular resistance in patients with hypoxic lung disease (Cuttica, 2016, Mohamed et al, 2019, Wrobel et al, 2012). We retrospectively studied a cohort of PTB patients who had measurement of pulmonary artery systolic pressure (PASP) by Doppler echocardiography in the active phase of tuberculosis, sought to investigate whether inflammatory markers, coagulation indicators, arterial blood gas parameters have correlation with the PASP values

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