Pulmonary arterial hypertension in schistosomiasis

Gavilanes, Francisca; Fernandes, Constantino José; Souza, Rogério

doi:10.1097/mcp.0000000000000300

Cited by 25 publications

(24 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…33 One of its most severe chronic complications is PAH. 15,34 Schistosomiasis-associated PAH (Sch-PAH) has undergone several distinct categories in previous classifications, depending on the emphasis on the inflammatory component or the embolic component associated with impaction of the eggs in the pulmonary circulation. 10,11,19 However, since 2008, it was included in group 1 such that the findings reinforced a vascular remodeling similar to that found in patients with IPAH.…”

Section: Schistosomiasismentioning

confidence: 99%

Pulmonary Hypertension: Definition, Classification, and Diagnosis

Alves

Oleas

Souza

2017

Semin Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

Pulmonary hypertension (PH) is a hemodynamic condition characterized by the presence of mean pulmonary artery pressure ≥ 25 mm Hg. Many different baseline conditions and/or risk factors are associated with the development of PH, increasing the complexity for the appropriate diagnosis and classification. Since it was first proposed, PH classification has been adapted to incorporate the increasing knowledge about the disease gathered along the past two decades. Current classification groups together the patients with similar pathophysiological mechanisms, clinical presentation, and management. Nevertheless, correct classification is only possible after a comprehensive diagnostic approach, assessing the most prevalent conditions associated with PH. Most importantly, left ventricular function, lung parenchyma, and the presence of chronic thromboembolic disease have to be evaluated by means of different diagnostic tools. The aim of this review is to summarize the current definitions of PH, which in turn is necessary for determination of the appropriate diagnostic approach.

show abstract

Section: Schistosomiasismentioning

confidence: 99%

Pulmonary Hypertension: Definition, Classification, and Diagnosis

Alves

Oleas

Souza

2017

Semin Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…Burada güçlü bir antijenik yanıt oluşturarak periportal fibrozis ve ardından portal hipertansiyona yol açar. Bu durumda portokaval şantlar açılır, akciğere kan akımı artar, yumurtalar akciğer kapillerine taşınır ve buraya yerleşir (1,2,3,8).…”

Section: Epi̇demi̇yoloji̇unclassified

“…Akut şisto-somiyazis genellikle kendini sınırlayan benign bir hastalıkken, kronik formu ciddi sağlık sorunlarına yol açabilmektedir (1). Pulmoner arteriyel hipertansiyon (PAH) kronik şistosomiyazisin en ağır komplikasyonlarından biri olup sağ kalp yetmezliği ve ölümle sonuçlanabilir (1,3).…”

Section: Introductionunclassified

See 1 more Smart Citation

Schistosomiasis and pulmonary hypertension

Şen

2017

Tuberk Toraks

View full text Add to dashboard Cite

show abstract

“…Schistosomiasis is the third most prevalent form of chronic infection disease worldwide, possibly infecting 200 million people [11]. Considering the prevalence of 5% of PAH in patients with the hepatosplenic form of the disease [3], Sch-PAH is clearly one of the most relevant forms of PAH, particularly in developing countries [12,13]. Nevertheless, this population is rarely included in the large trials evaluating PAH targeted therapies [14].…”

mentioning

confidence: 99%

Survival of patients with schistosomiasis-associated pulmonary arterial hypertension in the modern management era

et al. 2018

Self Cite

View full text Add to dashboard Cite

Pulmonary arterial hypertension (PAH) is a life-threatening disease characterised by an elevated pulmonary vascular resistance in the absence of left ventricular disease, and increasing pulmonary artery pressure, with consequent right ventricular failure and death [1]. Several aetiologies have been associated with PAH, including connective tissue diseases, congenital heart diseases and chronic infections, such as HIV. Due to its high prevalence in developing countries, one of the most relevant forms of PAH worldwide is the one associated to schistosomiasis [2]. Schistosomiasis-associated pulmonary arterial hypertension (Sch-PAH) is present in 5% of patients with the hepatosplenic form of the disease [3]. Due to its histological and haemodynamic similarities to idiopathic PAH (IPAH), it is classified within group 1 (pre-capillary pulmonary hypertension) of the current pulmonary hypertension classification [4]. However, despite the similarities, a previous cohort has shown that Sch-PAH has a distinct, more benign course than IPAH, even in the absence of specific therapy [5]. Data regarding the efficacy of specific PAH therapy in Sch-PAH are scarce. Improvements in functional class, cardiac output and 6-min walking test distance (6MWT), using phosphodiesterase-5 inhibitors (PDE5i) or endothelin-1 receptor antagonists (ERA) were demonstrated in a small cohort of 12 Sch-PAH patients [6]. The effect of PAH treatment on hard end-points, such as clinical worsening or survival, has not been evaluated in this population, until this date. The aim of this study was to compare the survival of newly diagnosed Sch-PAH patients treated with PAH targeted therapies against a group of untreated patients from a historical cohort. Data from all consecutive, newly diagnosed Sch-PAH patients referred to our centre in Brazil were analysed. Sch-PAH was characterised by the presence of mean pulmonary arterial pressure ⩾25 mmHg with pulmonary artery occlusion pressure ⩽15 mmHg, in the absence of significant lung parenchymal disease, left ventricular dysfunction or chronic thromboembolic disease, associated with the presence of periportal fibrosis and/or left liver lobe enlargement associated with at least one of the following features: positive epidemiology, previous treatment of schistosomiasis or identification of eggs in stool or rectal biopsy [7]. Since specific PAH therapy became widely available in Brazil after 2010, patients diagnosed before this date received only supportive therapy and comprised our historical cohort. After 2010, Sch-PAH patients were regularly treated with PDE5i, ERA or both, at discretion of the attending physician, in accordance to the available guidelines [8, 9]. Baseline clinical, demographical, including New York Heart Association (NYHA) functional class (FC) assessment, 6MWT, brain natriuretic peptide (BNP) and haemodynamic data were collected. Analysis was performed using the SPSS 21 statistical package (SPSS, Inc.). All continuous variables are expressed as mean±SD and compared using t-test. Categorical d...

show abstract

Pulmonary arterial hypertension in schistosomiasis

Cited by 25 publications

References 28 publications

Pulmonary Hypertension: Definition, Classification, and Diagnosis

Pulmonary Hypertension: Definition, Classification, and Diagnosis

Schistosomiasis and pulmonary hypertension

Survival of patients with schistosomiasis-associated pulmonary arterial hypertension in the modern management era

Contact Info

Product

Resources

About