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Severe pulmonary hypertension: data from the Swiss Registry
H Stricker1, G Domenighetti, W Popov
1Internal Medicine of Regional Hospital, Locarno. hans.stricker@eoc.ch
Swiss Medical Weekly
|August 7, 2001
Summary
Severe pulmonary hypertension (PH) is increasingly diagnosed, with primary forms and those linked to connective tissue or thromboembolic disease being common. The 6-minute walk test and functional class predict patient outcomes.
Area of Science:
- Cardiology
- Pulmonology
- Epidemiology
Background:
- Severe pulmonary hypertension (PH) is a rare, serious condition with limited data on prevalence and prognostic factors.
- Advances in diagnostics and therapeutics have renewed interest in PH.
- This study addresses the lack of data on PH unrelated to left ventricular failure or COPD.
Purpose of the Study:
- To determine the prevalence of severe PH unrelated to specific conditions.
- To identify associated conditions and prognostic indicators in PH patients.
- To analyze age distribution and diagnosis trends in PH.
Main Methods:
- Retrospective data collection from 5 Swiss centers up to December 1999.
- Analysis of clinical, hemodynamic, and associated disease parameters.
- Inclusion of age distribution and year of PH diagnosis.
Main Results:
- 106 patients with severe PH identified (median age 43); 79% in NYHA class III/IV.
- PH diagnoses rose significantly after 1995.
- Primary PH, collagen vascular disease, and thromboembolic disease accounted for 74% of etiologies.
- 30% mortality by study end.
- 6-minute walk test, NYHA class, and mixed venous saturation were key prognostic indicators.
- Treatments included calcium antagonists (18%) and prostanoids (33%); 7 lung transplants performed.
Conclusions:
- PH diagnosis is increasing with improved options.
- Primary, collagen vascular disease-associated, and thromboembolic PH are common.
- 6-minute walk test, functional class, and mixed venous saturation are crucial prognostic markers.