Universidade de Pernambuco, Departamento de Hipertensão Pulmonar, Pronto-Socorro Cardiológico de Pernambuco, Recife, PE, Brasil.
Universidade de Pernambuco, Departamento de Ecocardiografia, Recife, PE, Brasil.
Rev Soc Bras Med Trop. 2020 Feb 7;53:e20190418. doi: 10.1590/0037-8682-0418-2019. eCollection 2020.
Pulmonary arterial hypertension (PAH) is a serious pulmonary circulation disease caused by several etiologies, including schistosomiasis. The present study retrospectively evaluated the clinical and hemodynamic characteristics of patients with schistosomal PAH (PAH-Sch) compared to those of non-Sch PAH patients (non-Sch PAH).
Patients treated at the Pronto-Socorro Cardiológico de Pernambuco and diagnosed by right cardiac catheterization were divided into PAH-Sch and non-Sch PAH groups. Their socio-demographic and clinical characteristics, N-terminal-pro B-type natriuretic peptide (NT-proBNP), and echocardiography and hemodynamic parameters were retrospectively reviewed.
Among the included 98 patients (mean age, 45 ± 14 years; 68 women [69.4%]), we found 56 PAH-Sch and 42 non-Sch PAH. The age distribution was heterogeneous in the PAH-Sch group, with patients predominantly ranging from 50-59 (p <0.004). Dyspnea was the most common symptom, reported by 92 patients (93.8%), and commonly present for over two years prior to diagnosis. Clinical symptoms were similar in both groups, with no differences in functional class, pulmonary artery systolic pressure (p = 0.102), 6-minute walk test score (p = 0.234), NT-proBNP serum levels (p = 0.081), or hemodynamic parameters.
Patients with PAH-Sch present clinical, laboratory, and hemodynamic profiles similar to those with PAH resulting from other etiologies of poor prognosis. PAH is an important manifestation of schistosomiasis in endemic regions that is often diagnosed late.
肺动脉高压(PAH)是一种由多种病因引起的严重肺循环疾病,包括血吸虫病。本研究回顾性评估了血吸虫性 PAH(PAH-Sch)患者与非-Sch PAH 患者的临床和血流动力学特征。
在 Pronto-Socorro Cardiológico de Pernambuco 接受治疗并通过右心导管诊断的患者被分为 PAH-Sch 和非-Sch PAH 组。回顾性分析了他们的社会人口统计学和临床特征、N 端脑利钠肽前体(NT-proBNP)以及超声心动图和血流动力学参数。
在纳入的 98 名患者(平均年龄 45±14 岁;68 名女性[69.4%])中,我们发现 56 名 PAH-Sch 和 42 名非-Sch PAH。PAH-Sch 组的年龄分布不均匀,患者主要分布在 50-59 岁(p<0.004)。呼吸困难是最常见的症状,92 名患者(93.8%)有此症状,且在诊断前通常已存在两年以上。两组的临床症状相似,在功能分级、肺动脉收缩压(p=0.102)、6 分钟步行试验评分(p=0.234)、NT-proBNP 血清水平(p=0.081)或血流动力学参数方面均无差异。
PAH-Sch 患者的临床表现、实验室和血流动力学特征与其他病因导致的预后不良的 PAH 相似。在流行地区,PAH 是血吸虫病的一个重要表现,往往诊断较晚。