Profile Of Pulmonary Hypertension Research Articles

Profile of Pulmonary Hypertension in Patients Presenting with Respiratory Symptoms at a Tertiary Care Hospital in Mumbai

ABSTRACT Background: Pulmonary hypertension (PH) is a disorder of the pulmonary vasculature caused due to vasoconstriction, vaso-destruction, or vaso-obliteration as a complication of a varied spectrum of diseases referred to a pulmonologist. We conducted this study to contemplate the profile of PH in a tertiary care hospital in Mumbai. Methodology: This was an observational study undertaken in the department of pulmonary medicine at a tertiary care center after internal ethical committee approval. Patients with respiratory symptoms referred to us with PH as estimated pulmonary artery systolic pressure (PASP) of ≥40 mmHg by transthoracic two-dimensional echocardiography (corresponding to mean pulmonary artery pressure of ≥25 mmHg) were included in the study. The profile of these patients was studied on basis of parameters such as demography, etiology, symptomatology, radiological features, 6-min walk distance (6-MWD), and spirometry. Data were analyzed using Microsoft Excel software. Results: Among 347 patients, 54% were men. Majority of the patients (53.5%) were aged between 45 and 65 years. The most common symptom was dyspnea (86%). The most common examination finding was loud pulmonary component of second heart sound (62%). The common etiologies of PH were postinfectious obliterative bronchiolitis (OB) 30%, interstitial lung diseases 26%, chronic obstructive pulmonary disease 24%, and obstructive sleep apnea 14%. There was a negative correlation between 6-MWD, forced vital capacity % predicted, forced expiratory volume in 1st s % predicted, and PASP. Conclusion: Airway disease is the most common etiology of PH in patients presenting to a pulmonologist in India, out of which postinfectious OB forms the major bulk.

Profile of pulmonary hypertension amongst patients seen with left heart failure in a Ghanaian hospital

Introduction: the development of pulmonary hypertension in left heart failure is an independent predictor of poor outcomes. We assessed the burden and predictors of pulmonary hypertension amongst patients with left heart failure presenting to the cardiology unit of Korle Bu Teaching Hospital, Ghana.

Pulmonary hypertension in eosinophilic versus noneosinophilic COPD.

BackgroundThe eosinophilic COPD phenotype is associated with greater airway remodelling, exacerbation risk and steroid responsiveness. However, little is known about the prevalence and characteristics of pulmonary hypertension (PH) in this patient population.MethodsWe retrospectively evaluated a cohort of COPD patients with right heart catheterisation (RHC) data at a university hospital between January 2011 and May 2019 and compared the pulmonary vascular profile and prevalence of PH between eosinophilic and noneosinophilic patients using a definition of eosinophilic COPD as at least three blood eosinophil values ≥300 cells·µL−1. We used multivariable logistic regression analyses to examine the association between eosinophilic COPD and various PH categories adjusting for age, sex, body mass index, forced expiratory volume in 1 s (%), smoking status and use of supplemental oxygen.ResultsAmong 106 COPD patients with RHC data and at least three blood eosinophil values, 25% met the definition of eosinophilic COPD. Fewer patients among the eosinophilic group required long-term oxygen therapy (69% versus 93%, p=0.001) and total lung capacity was significantly lower in the eosinophilic group (p=0.006). This group had higher mean pulmonary arterial pressure (mPAP) (median (interquartile range) 30 (27–41) mmHg versus 25 (22–30) mmHg, p=0.001) and pulmonary vascular resistance (PVR) (4 (2.8–5.1) Wood units versus 2.9 (2.1–4.1) Wood units, p=0.018). On multivariable logistic regression analyses, eosinophilic phenotype was associated with PH (adjusted (a)OR 6.5, 95% CI 1.4–30.7; p=0.018) and pre-capillary PH (aOR 3.2, 95% CI 1.1–9; p=0.027), but not severe PH (aOR 2.1, 95% CI 0.6–7.2; p=0.219).ConclusionEosinophilic COPD was associated with higher mPAP and PVR and increased likelihood of PH. More studies are needed to further explore this finding.

Clinicoradiological and Cardiac Profile of Pulmonary Artery Hypertension in Treated Patients of Pulmonary Tuberculosis in a Tertiary Center

Introduction: Tuberculosis (TB) is a global health burden. Pulmonary TB (PTB) can cause important thoracic sequelae involving the lungs, airways, vessels, mediastinum, pleura, and chest wall. Pulmonary hypertension (PAH) is a serious respiratory disability occurring from structural lung damage and chronic hypoxia. Aims and Objectives: The aim of this study is to evaluate the clinical, radiological, and echocardiographic profile of PAH in patients treated for PTB and how they correlate with each other. Patients and Methods: This was a cross-sectional study. A total of 100 patients with PAH with a history of PTB were analyzed. Chest X-ray, electrocardiogram (ECG), and two-dimensional-echocardiography were obtained in all of them. Detailed clinical and radiological profile of those having PAH was noted. The usefulness of echocardiography for diagnosing cor pulmonale was studied. Results: We investigated 75 males and 25 females. Cough was the most common presenting symptom. The mean time since the treatment of PTB was 7.5 years. The most common radiological abnormality, fibrocavitation was found in 25% of the patients, whereas P-pulmonale was the most common finding on ECG. Majority of the patients had moderate PAH with a pulmonary arterial systolic pressure 50–65 mmHg. There was a significant relationship between PAH and tricuspid regurgitation (TR) (P

Clinical and epidemiological profile of pulmonary hypertension

Clinical and epidemiological profile of pulmonary hypertension

Profile of pulmonary hypertension in a tertiary care PICU in South India

Profile of pulmonary hypertension in a tertiary care PICU in South India

Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.

BackgroundPulmonary hypertension (PH) was recently recognized as a common complication of end-stage renal disease (ESRD) that causes an increased risk of mortality. Epidemiological data for this disorder in earlier stages of chronic kidney disease (CKD) and its association with cardiovascular (CV) morbidity are scarce.MethodsWe retrospectively analyzed 2,351 Chinese CKD patients with complete clinical records and echocardiography data between Jan 2008 and May 2012. The patients were divided into the following 6 groups: CKD Stages 1–4; Stage 5 for those not on or initiated on hemodialysis for <3 months; and Stage 5D for the patients undergoing hemodialysis for ≥3 months. The prevalence of PH and CV morbidity was investigated, and their association was evaluated with a logistic regression model.ResultsPH was detected in 426 patients (18.1%). Mild, moderate and severe PH was diagnosed in 12.1%, 4.9% and 1.1% of the patients, respectively. Severe PH was detected in CKD Stages 5 and 5D. CV morbidity was found in 645 patients (27.4%). Compared with the non-PH group, the PH group had a higher risk for cardiac disease but not for cerebrovascular disease risk. PH severity was associated with cardiac morbidity risk [odds ratio (95% CI) for mild PH: 1.79 (1.30–2.47); moderate PH: 2.75 (1.73–4.37); severe PH: 3.90 (1.46–10.42)].ConclusionsOur study showed for the first time the epidemiology profile of PH across the spectrum of CKD. Mild-to-moderate PH occurs with more frequency in advanced CKD, and severe PH is scarce in non-ESRD CKD. PH in CKD is associated with cardiac but not cerebrovascular disease, with increasing cardiac morbidity seen with increasing PH severity. Evidence from prospective studies addressing PH in this population is needed to predict cardiac events.