Correlation between Degrees of Pulmonary Hypertension and Findings in Complementary Tests

Abstract

Introduction: Pulmonary hypertension is potentially fatal and courses with important day-today limitation. While the treatment is capable of slowing the disease's progression, increase in life expectancy is directly linked to early diagnosis and treatment. Objectives: To analyze the relation between alterations detectable on routine exams performed on pulmonary hypertension patients (echocardiography, electrocardiography and computerized tomography) and increases on pulmonary artery systolic pressure. Methods: We analyzed the recordings of patients presented with pulmonary hypertension, and separated them in two groups based on their echocardiography-estimated pulmonary artery systolic pressure. Group 1 was composed of patients with pulmonary artery systolic pressure between 35 mmHg and 65 mmHg, and Group 2 of patients with pulmonary artery systolic pressure > 65 mmHg. We analyzed the prevalence of alterations suggestive of pulmonary hypertension on echocardiography, electrocardiography and computerized tomography. A descriptive analysis of the findings was conducted, followed by comparative analysis between the groups. Results: We analyzed 101 patients (43 from Group 1 and 58 from Group 2). Most were women (82). Higher pulmonary artery systolic pressure values were correlated with right-heart dilation on echocardiography (p < 0.001). Electrocardiography findings revealed that right-heart hypertrophy and ventricular strain pattern were more common on Group 2 (p < 0.05). Computerized tomography analysis showed Group 2 patients had superior pulmonary artery diameters (p < 0.05). There was correlation between high pulmonary artery systolic pressure and clinical progression of the disease measured via the NYHA score (p < 0.05). Conclusion: It is possible to make use of clinical examination and a simple electrocardiography to stratify the severity of a pulmonary artery patient. Computerized tomography and echocardiography should be used to confirm these findings.