Prevalence and Aetiology of Pulmonary Hypertension in a Tertiary Hospital Setting

Abstract

Background: With new therapies for pulmonary arterial hypertension (PAH), early initiation of treatment has become an important goal. Left heart disease and pulmonary disease are more common precipitants of pulmonary hypertension and similarly require appropriate recognition and therapy. Aims: We sought to evaluate the prevalence and aetiology of pulmonary hypertension in a cohort of patients referred for inpatient echocardiography at a tertiary institution. Methods: All echocardiograms performed at the John Hunter Hospital between 2005 and 2010 were included in the analysis; demographic and echocardiographic data was extracted from the institutional echocardiography database. Patients were considered to have significant pulmonary hypertension if the estimated systolic pulmonary artery pressure was greater than 45 mmHg. Pulmonary hypertension was classified as secondary to PAH, left heart disease, underlying pulmonary disease (including sleep disordered breathing, obstructive and restrictive lung disease) or congenital heart disease. Results: A total of 332 cases of pulmonary hypertension were documented.Tabled 1DiagnosisN (%)MaleFemaleBSAsPAPMean ± ageCongenital heart disease7 (2.1%)341.766.055 ± 8.0Pulmonary disease58 (17.5%)27312.064.771 ± 1.7Left heart disease240 (72.3%)1281071.875.375 ± 0.8PAH27 (8.1%)14121.972.766 ± 2.2 Open table in a new tab Conclusions: In a contemporary inpatient population in a large tertiary referral hospital, pulmonary hypertension was most likely to complicate left heart and pulmonary disease, particularly when compared to PAH.