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• W3200497138 abstract "Background Pulmonary Hypertension is a clinical condition found in a wide variety of cardiac, pulmonary and systemic disorders. It is highly prevalent amongst heart failure subjects and now recognized as an independent marker of poor prognosis. There is a paucity of data on pulmonary hypertension amongst heart failure subjects in our population. Studies on this subject will help us in better risk stratification, management and prognostication of our heart failure patients. Objectives The aim of this study was to identify the frequency and assess the clinical and echocardiographic correlates of pulmonary hypertension amongst heart failure subjects managed at the Lagos University Teaching Hospital. Methods This was a cross-sectional study in which 219 heart failure patients in NYHA II-IV were consecutively recruited from the emergency room and the cardiology out-patient clinic. Heart failure patients with other co-morbidities that can cause pulmonary hypertension were excluded. A brief history, clinical examination and echocardiography were performed on all subjects. The clinical and echocardiographic characteristics of subjects with and without pulmonary hypertension were compared. The correlation between clinical and echocardiographic variables with pulmonary artery systolic pressure (PASP) and mean pulmonary systolic pressure (mPAP) were evaluated. Results  The frequency of PH was determined by two criteria. PH using a PASP cut off of >36mmHg was present in 85 (38.8%) of subjects. However, using the mPAP criteria of ≥ 25mmHG, PH was present in 135 (61.6%) of subjects. Heart failure subjects with pulmonary hypertension were more likely to be male with a lower BMI, lower systolic blood pressure and a worse NYHA functional class compared with subjects without pulmonary hypertension. Hypertensive heart disease was the commonest cause of heart failure (48.9%) and it occurred less frequently in subjects with PH, while dilated cardiomyopathy and valvular heart disease were more frequent in them. Heart failure subjects with PH also had significantly higher LV filling pressures, (higher left atrial volume index and E/e’ratio), more severe mitral regurgitation (higher mitral regurtitant volume), poorer LV systolic function, and worse parameters RV structure and function compared with those without PH. Echocardiographic variables that correlated significantly PASP include parameters of LV filling pressures (p 0.001), RV structure and function (TAPSE, r = -0.428, p < 0.001). Similar correlations were obtained with mPAP. On multivariate analyses, the left atrial volume index and E/e’ ratio were independently associated with PASP, while the LV ejection fraction, E/e’ ratio and the left atrial volume index were independently associated with mPAP. Conclusion PH is quite common amongst HF subjects in our tertiary hospital setting with a variable frequency depending on the assessment method employed. It is associated with higher LV filling pressure, more severe MR, poorer LV systolic function and worse RV remodeling. Routine screening for PH amongst HF patients is recommended for better prognostication and management." @default.
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• W3200497138 date "2016-01-01" @default.
• W3200497138 modified "2023-09-27" @default.
• W3200497138 title "CLINICAL AND ECHOCARDIOGRAPHIC CORRELATES OF PULMONARY HYPERTENSION AMONGST PATIENTS WITH HEART FAILURE" @default.
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