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The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE)
Whereas younger female patients were diagnosed with idiopathic pulmonary arterial hypertension (IPAH) in 1980s, it is now frequently encountered in elderly patients with cardiovascular comorbidities (CVCs) associated with increased risk for left heart disease. We present data until November 2019 reg...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171835/ https://www.ncbi.nlm.nih.gov/pubmed/35685948 http://dx.doi.org/10.1002/pul2.12086 |
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author | Arvanitaki, Alexandra Vrana, Elena Boutsikou, Maria Anthi, Anastasia Apostolopoulou, Sotiria Avgeropoulou, Aikaterini Demerouti, Eftychia Patrianakos, Alexandros Karyofyllis, Panagiotis Mitrouska, Ioanna Mouratoglou, Sophia A. Naka, Katerina K. Orfanos, Stylianos E. Panagiotidou, Evangelia Pitsiou, Georgia Rammos, Spyridon Stanopoulos, Ioannis Thomaidi, Adina Frogoudaki, Alexandra Boutou, Afroditi Anastasiadis, George Brili, Styliani Tsangaris, Iraklis Tsiapras, Dimitrios Voudris, Vassilios Manginas, Athanasios Giannakoulas, George |
author_facet | Arvanitaki, Alexandra Vrana, Elena Boutsikou, Maria Anthi, Anastasia Apostolopoulou, Sotiria Avgeropoulou, Aikaterini Demerouti, Eftychia Patrianakos, Alexandros Karyofyllis, Panagiotis Mitrouska, Ioanna Mouratoglou, Sophia A. Naka, Katerina K. Orfanos, Stylianos E. Panagiotidou, Evangelia Pitsiou, Georgia Rammos, Spyridon Stanopoulos, Ioannis Thomaidi, Adina Frogoudaki, Alexandra Boutou, Afroditi Anastasiadis, George Brili, Styliani Tsangaris, Iraklis Tsiapras, Dimitrios Voudris, Vassilios Manginas, Athanasios Giannakoulas, George |
author_sort | Arvanitaki, Alexandra |
collection | PubMed |
description | Whereas younger female patients were diagnosed with idiopathic pulmonary arterial hypertension (IPAH) in 1980s, it is now frequently encountered in elderly patients with cardiovascular comorbidities (CVCs) associated with increased risk for left heart disease. We present data until November 2019 regarding specific features and clinical outcomes of IPAH population from the Hellenic Pulmonary Hypertension Registry (HOPE). Patients were divided into two groups based on the presence of ≥ or <3 CVCs, arterial hypertension, diabetes mellitus, obesity, presence of coronary artery disease, or atrial fibrillation. Overall, 77 patients with IPAH (55.1 [interquartile range, IQR: 24.1] years, 62.8% women) have been recorded. Fifteen patients (19.2%) had ≥3 CVCs, while 25 (32%) were over 65 years old. Patients with ≥3 CVCs were older, presented an almost equal female to male ratio, walked less in 6‐min walk test, and had lower mean arterial pulmonary pressure and pulmonary vascular resistance at baseline than patients with less CVCs. Fewer patients with ≥3 CVCs received PAH‐specific treatment compared to patients with less comorbidities (n = 11 [73.3%] versus n = 58 [95.5%], p = 0.02). During a median follow‐up period of 3.8 (IQR: 2.7) years, 18 patients died (all‐cause mortality 24.3%). Male sex and older age were independent predictors of mortality and/or lung transplantation, while CVCs did not have a significant impact on clinical outcomes. In this nationwide, register‐based study, the epidemiology of IPAH involves older patients with CVCs, who seem to have less hemodynamic compromise, but worse functional impairment and are treated less aggressively with PAH pharmacotherapy. |
format | Online Article Text |
id | pubmed-9171835 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91718352022-06-08 The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) Arvanitaki, Alexandra Vrana, Elena Boutsikou, Maria Anthi, Anastasia Apostolopoulou, Sotiria Avgeropoulou, Aikaterini Demerouti, Eftychia Patrianakos, Alexandros Karyofyllis, Panagiotis Mitrouska, Ioanna Mouratoglou, Sophia A. Naka, Katerina K. Orfanos, Stylianos E. Panagiotidou, Evangelia Pitsiou, Georgia Rammos, Spyridon Stanopoulos, Ioannis Thomaidi, Adina Frogoudaki, Alexandra Boutou, Afroditi Anastasiadis, George Brili, Styliani Tsangaris, Iraklis Tsiapras, Dimitrios Voudris, Vassilios Manginas, Athanasios Giannakoulas, George Pulm Circ Research Articles Whereas younger female patients were diagnosed with idiopathic pulmonary arterial hypertension (IPAH) in 1980s, it is now frequently encountered in elderly patients with cardiovascular comorbidities (CVCs) associated with increased risk for left heart disease. We present data until November 2019 regarding specific features and clinical outcomes of IPAH population from the Hellenic Pulmonary Hypertension Registry (HOPE). Patients were divided into two groups based on the presence of ≥ or <3 CVCs, arterial hypertension, diabetes mellitus, obesity, presence of coronary artery disease, or atrial fibrillation. Overall, 77 patients with IPAH (55.1 [interquartile range, IQR: 24.1] years, 62.8% women) have been recorded. Fifteen patients (19.2%) had ≥3 CVCs, while 25 (32%) were over 65 years old. Patients with ≥3 CVCs were older, presented an almost equal female to male ratio, walked less in 6‐min walk test, and had lower mean arterial pulmonary pressure and pulmonary vascular resistance at baseline than patients with less CVCs. Fewer patients with ≥3 CVCs received PAH‐specific treatment compared to patients with less comorbidities (n = 11 [73.3%] versus n = 58 [95.5%], p = 0.02). During a median follow‐up period of 3.8 (IQR: 2.7) years, 18 patients died (all‐cause mortality 24.3%). Male sex and older age were independent predictors of mortality and/or lung transplantation, while CVCs did not have a significant impact on clinical outcomes. In this nationwide, register‐based study, the epidemiology of IPAH involves older patients with CVCs, who seem to have less hemodynamic compromise, but worse functional impairment and are treated less aggressively with PAH pharmacotherapy. John Wiley and Sons Inc. 2022-06-07 /pmc/articles/PMC9171835/ /pubmed/35685948 http://dx.doi.org/10.1002/pul2.12086 Text en © 2022 The Authors. Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Research Articles Arvanitaki, Alexandra Vrana, Elena Boutsikou, Maria Anthi, Anastasia Apostolopoulou, Sotiria Avgeropoulou, Aikaterini Demerouti, Eftychia Patrianakos, Alexandros Karyofyllis, Panagiotis Mitrouska, Ioanna Mouratoglou, Sophia A. Naka, Katerina K. Orfanos, Stylianos E. Panagiotidou, Evangelia Pitsiou, Georgia Rammos, Spyridon Stanopoulos, Ioannis Thomaidi, Adina Frogoudaki, Alexandra Boutou, Afroditi Anastasiadis, George Brili, Styliani Tsangaris, Iraklis Tsiapras, Dimitrios Voudris, Vassilios Manginas, Athanasios Giannakoulas, George The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) |
title | The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) |
title_full | The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) |
title_fullStr | The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) |
title_full_unstemmed | The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) |
title_short | The impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: Data from the Hellenic Pulmonary Hypertension Registry (HOPE) |
title_sort | impact of cardiovascular comorbidities associated with risk for left heart disease on idiopathic pulmonary arterial hypertension: data from the hellenic pulmonary hypertension registry (hope) |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171835/ https://www.ncbi.nlm.nih.gov/pubmed/35685948 http://dx.doi.org/10.1002/pul2.12086 |
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