BackgroundSchistosomiasis-associated pulmonary arterial hypertension (SPAH) is a major
concern worldwide. However, the role of gender specific contributing factors in
SPAH is unknown. ObjectiveWe investigated how systolic pulmonary artery pressure (SPAP) values and the
presence of severe SPAP relate to gender, menopausal status, and pregnancy history
in SPAH patients. MethodsSeventy-nine patients diagnosed with SPAH from 2000 to 2009 were assessed and 66
were enrolled in the study. Information about age, menopausal status, pregnancy,
echocardiography-derived SPAP, and invasive mean pulmonary artery pressure (mPAP)
was collected from medical records. The relation between values of SPAP and mPAP
and their agreement for severe disease were assessed. Regression models assessed
the association of gender, menopausal status, and pregnancy history with SPAP
values and the presence of severe SPAP. ResultsModerate correlation and good agreement for severe disease were found between mPAP
and SPAP. Mean SPAP values were similar for men and women. A trend toward higher
values of SPAP was found for non-menopausal women compared to men. Higher SPAP
values were found for menopausal compared to non-menopausal women; the values were
non-significant after adjustment for age. Pregnancy history had no association
with SPAP. Menopause and positive pregnancy had no association with severe SPAP.
ConclusionIn SPAH patients, neither gender, nor menopausal status, nor pregnancy history
showed independent correlation with SPAP values assessed by echocardiography.
Relato de Caso RESUMO A hipertensão arterial pulmonar frequentemente está associada a dor torácica com características anginosas e sua etiologia é desconhecida. A compressão extrínseca do tronco de artéria coronária esquerda pela artéria pulmonar é uma causa tratável e deve ser considerada. É apresentado o caso de uma paciente com hipertensão arterial pulmonar de etiologia esquistossomótica, com angina do peito decorrente de compressão do tronco de artéria coronária esquerda, que foi tratada com stent intracoronário. Os sinais e sintomas isquêmicos foram completamente resolvidos e a ultrassonografia intracoronária, realizada na evolução tardia, mostrou a consolidação do resultado angiográfico.
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