Clinical and hemodynamic profile of patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in a tertiary hospital of São Paulo
DOI:
https://doi.org/10.11606/issn.1679-9836.v101i6e-184119Keywords:
Epidemiology, Pulmonary arterial hypertension, Pulmonary hypertensionAbstract
Objective. To describe the clinical and hemodynamic characteristics of patients with Pulmonary Arterial Hypertension (PAH) and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) treated at the Hospital do Servidor Público Estadual of São Paulo (HSPE). Methods. The medical records of patients under follow-up between 2012 and 2019 at the Pulmonary Circulation ambulatory of HSPE were reviewed. Pulmonary hypertension was confirmed by right cardiac catheterization, as well as the final diagnosis of PAH or CTEPH was confirmed after specialized evaluation. Results. Forty-six cases of pulmonary hypertension were evaluated, 31 of which were PAH and 15 of CTEPH. The mean age overall was 67.5 (± 10,5) years, with a frequency of participants over 60 years of 73,9%. There was a predominance of females (69,6%). The median of dyspnea until diagnosis was 2 years. The main etiology of PAH was systemic sclerosis and there were no cases of schistosomiasis in the studied population. There were signs of right ventricle dysfunction at the time of diagnosis in 73,3% of cases. Among patients with CTEPH, 46,7% were unaware of previous thromboembolic events. Conclusions. This study addressed a predominantly elderly population diagnosed with pulmonary hypertension, highlighting the characteristics of two subtypes of the disease. There is a need for further studies to improve the understanding of PH in the Brazilian population, especially on patients with CTEPH.
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Simonneau G, Montani D, Celermajer DS, Denton CP, Gatzoulis MA, Krowka M, Williams PG, Souza R. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019; 53(1):1801913. https://doi.org/10.1183/13993003.01913-2018
Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension. Rev Esp Cardiol (Engl Ed). 2016;69(2):177. https://doi.org/10.1016/j.rec.2016.01.002
Sablinskis K, Sablinskis M, Lejnieks A, Skride A. Growing number of incident pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension patients in Latvia: a shifting epidemiological landscape? Data from a national pulmonary hypertension registry. Eur J Intern Med. 2019;59:e16-e17. https://doi.org/10.1016/j.ejim.2018.09.017
Hoeper M, Huscher D, Ghofrani HA, Delcroix M, Distler O, Schweiger C, et al. Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the COMPERA registry. Int J Cardiol. 2013;168:871-880. https://doi.org/10.1016/j.ijcard.2012.10.026
Lapa MS, Ferreira EV, Jardim C, Martins BC, Arakaki JS, Souza R. Características clínicas dos pacientes com hipertensão pulmonar em dois centros de referência em São Paulo. Rev Assoc Med Bras 2006;52:139-143. https://doi.org/10.1590/S0104-42302006000300012
Alves JL Jr, Gavilanes F, Jardim C, Fernandes CJCDS, Morinaga LTK, Dias B, et al. Pulmonary arterial hypertension in the southern hemisphere: results from a registry of incident Brazilian cases. Chest. 2015;147(2):495-501. https://doi.org/10.1378/chest.14-1036
Song S, Lee SE, Oh SK, Jeon SA, Sung JM, Park JH, et al. Demographics, treatment trends, and survival rate in incident pulmonary artery hypertension in Korea: A nationwide study based on the health insurance review and assessment service database. PLoS One. 2018;13(12):e0209148. https://doi.org/10.1371/journal.pone.0209148
Badesch DB, Raskob GE, Elliott CG, Krichman AM, Farber HW, Frost AE, et al. Pulmonary arterial hypertension: baseline characteristics from the REVEAL Registry. Chest. 2010;137(2):376-387. https://doi.org/10.1378/chest.09-1140
Escribano-Subias P, Blanco I, López-Meseguer M, Lopez-Guarch CJ, Roman A, Morales P et al. Survival in pulmonary hypertension in Spain: insights from the Spanish registry. Eur Respir J. 2012;40(3):596-603. https://doi.org/10.1183/09031936.00101211
Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011;124(18):1973-1981. https://doi.org/10.1161/CIRCULATIONAHA.110.015008
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