clinical profile of patients with pulmonary hypertension due to lung diseases ( single center experience)

Conditions: Pulmonary Hypertension

Summary: development of pulmonary hypertension (ph) in chronic lung diseases has both functional and prognostic implications . ph in lung diseases is usually mild to moderate with preserved cardiac output, and evolves slowly alongside the progression of lung disease and hypoxemia . however, a minority of patients develop severe ph with elevations in pulmonary artery pressure that have been described as ''out of proportion'' to the underlying disease . the aim of this study is to compare the characteristics and outcomes of consecutive patients with ph-due to lung diseases diagnosed at our specialist referral center over a 1-year period.

development of pulmonary hypertension (ph) in chronic lung diseases has both functional and prognostic implications . ph in lung diseases is usually mild to moderate with preserved cardiac output, and evolves slowly alongside the progression of lung disease and hypoxemia . however, a minority of patients develop severe ph with elevations in pulmonary artery pressure that have been described as ''out of proportion'' to the underlying disease . hypotheses for the etiology of this phenotype include greater susceptibility to alveolar hypoxia and/or tobacco smoke , destruction of the capillary vascular bed , inflammatory factors initiating remodeling of the pulmonary vascular bed or the coexistence of idiopathic pulmonary arterial hypertension (ipah) in patients with lung disease . severe ph-lung disease has been arbitrarily defined by a resting mean pulmonary artery pressure (pap) ≥35 mmhg by rhc . the high and increasing prevalence of chronic lung diseases and the substantial consequences of developing severe ph have generated increasing interest in ph-lung diseases. pulmonary vascular research unit at chest department at kasr-alani school of medicine delivers regional, adult ph service to a population with a chronic lung disease. the aim of this study is to compare the characteristics and outcomes of consecutive patients with ph-due to lung diseases diagnosed at our specialist referral center over a 1-year period. patients diagnosed as chronic lung diseases( copd,ild,osa,sarcoidosis) will be recruited from out-patient's clinics \& inpatients wards of internal medicine \& chest departments, kasr al-ainy hospital (from june 2016 to may 2015) a written informed consent matching with helsinki declaration will be taken from all patients. 2.2 study methods: all the enrolled patients will go through the following basically: 1. detailed standard demographic \& clinical parameters. 2. assessment of exercise tolerance (6 mwd \& who functional capacity) 3. assessment of pulmonary function by pfts. 4. ecg: (right ventricular strain,right axis deviation,right bundle branch block,\& left side changes 0 5. echocardiographic evaluation for pah: ( right atrial area ,right ventricular area ,tricuspid regurgitant jet velocity (tr) ,tricuspid annular plane systolic excursion) 6. radiography: including chest x-ray, hrct chest, v/q scan\& ct angiography if needed 10. rt sided heart catheterization: * mpap * pcwp * pvr * cardiac index 11. statistical analysis: ........ the subjects will be classified according to rhc into either * non pah groups mpap ≤ 21mmhg * pah mpap≥ 25 mmhg: * severe ph-lung diseases mpap ≥ 35 mmgh

Eligibility criteria:
inclusion criteria: 1. copd diagnosed according to gold 2015 2. interstial lung diseases 3. obstructive sleep apnea 4. sarcoidosis exclusion criteria: * bronchogenic carcinoma

Keywords: pulmonary hypertension copd ild osa