Pulmonary hypertension registry of Kerala, India (PRO-KERALA) — Clinical characteristics and practice patterns

Harikrishnan, S; Sanjay, G.; Ashishkumar, M; Menon, Jaideep; Rajesh, Gopalan Nair; Kumar, Raman; Koshy, A. George; Attacheril, Thankachan V.; George, Raju; Punnoose, Eapen; Ashraf, Sunya; Arun, Sumitha; Cholakkal, Mohammed; Jeemon, Panniyammakal

doi:10.1016/j.ijcard.2018.02.036

Cited by 12 publications

(16 citation statements)

References 24 publications

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“…Geoffe et al reported 9.1% prevalence of PHT and 6.6% prevalence was reported in INCIPIT study. 14 The commonest aetiological type of Pulmonary hypertension in our study is Group II Pulmonary hypertension (72.7%) which is slightly higher than 59% reported in Prokerala registry 15 and similar to 69% reported in PAPUCO study at Africa by friedrich Thieneman 16 and 68% reported by Geoff strange et al 17 The Group II Pulmonary hypertension can be a consequence of left ventricular dysfunction, mitral (or) Aortic Valve disease, and cor-triatriatum. In our study patients with Group II PHT 51.71% (37.59% among overall patients with PHT) had rheumatic valvular heart disease and 48.29%.…”

Section: Discussionsupporting

confidence: 78%

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A Study of W.H.O. Group Ii Pulmonary Hypertension by Echocardiography in a Tertiary Care Institute, Tamilnadu, South India

Govindharaju¹,

Gopalakrishnan²

2018

jebmh

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BACKGROUNDPulmonary hypertension is a progressive disease with high morbidity and mortality. The W.H.O. Group II Pulmonary hypertension (Pulmonary hypertension due to left heart disease) is the most prevalent form of PHT worldwide. There is paucity of data regarding Group II Pulmonary hypertension from developing countries including India. This retrospective descriptive study was carried out at a tertiary care institute with an objective of establishing the epidemiological data of Group II Pulmonary hypertension by Echocardiography. MATERIALS AND METHODSAll patients who were referred for the first time echo between January 2016 and December 2016 were included and analysed in this study. Echocardiogram was performed by consultant cardiologist using Philips HD11XE and ALOKA SSD-4000 echo machines following ASE Guidelines. Pulmonary artery systolic pressure was derived from tricuspid regurgitation jet velocity by modified Bernoulli equation with the addition of estimated right atrial pressure. The standard echo doppler techniques were applied to diagnose the presence of left sided valvular diseases and left ventricular dysfunction by following ASE guidelines. RESULTSIn our study of 17,625 cases, 282 (16%) patients were diagnosed as pulmonary hypertension. The WHO Group II pulmonary hypertension (pulmonary hypertension caused by left heart disease) is the commonest echo group (72.7%) present in our study. Among the patients with Group II pulmonary hypertension 51.71% had rheumatic left sided valvular heart disease and 48.29% had LV dysfunction due to CAD and cardiomyopathy. RHD was more common in female (71.70%) while LV dysfunction was more common in male (67.68%). The mean age Group in our study was 35-45 years. Patients with combined mitral stenosis and mitral regurgitation (42.45%) commonly presented with significant pulmonary hypertension. Among the Group II PHT patients with LV dysfunction, 80.81% had LV systolic dysfunction with reduced ejection fraction and 19.91% had LV diastolic dysfunction with normal EF. The functional mitral regurgitation was present in 67.68% of patients with LV systolic dysfunction. CONCLUSIONThe Group II pulmonary hypertension (PHT due to left heart disease) is the leading cause of pulmonary hypertension. The rheumatic left sided valvular heart disease and LV dysfunction due to CAD and cardiomyopathy are the major causes of Group II pulmonary hypertension. The early diagnosis of the underlying left heart disease by echocardiography and its timely correction may improve the survival of the patients with Group II pulmonary hypertension.

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Section: Discussionsupporting

confidence: 78%

“…This is in accordance with PRO-Kerala Registry report. 15 The LV dysfunction was the second most common cause of Pulmonary Hypertension in our study. The LV dysfunction may be systolic LV dysfunction with reduced EF (or) Diastolic LV dysfunction with Normal EF.…”

Section: Discussionmentioning

confidence: 51%

A Study of W.H.O. Group Ii Pulmonary Hypertension by Echocardiography in a Tertiary Care Institute, Tamilnadu, South India

Govindharaju¹,

Gopalakrishnan²

2018

jebmh

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“…PROKELARA included all PH categories and showed that Group 2 PH was the prevalent type of PH. Within Group 1 PH, 66% of patients had associated CHD 3 . It is likely that PH is far more prevalent in India compared to the Western world not only due to a larger population but also due to a higher prevalence of co‐morbid conditions that lead to PH such as rheumatic mitral valve disease and untreated CHD.…”

Section: Discussionmentioning

confidence: 99%

“…It is likely that PH is far more prevalent in India compared to the Western world not only due to a larger population but also due to a higher prevalence of co‐morbid conditions that lead to PH such as rheumatic mitral valve disease and untreated CHD. The PROKERALA registry noted that etiology of PH is significantly different in India compared to the Western world and found that only one out of two Group 1 PH patients received pulmonary vasodilator therapies 3 . This likely holds true for other LMICs that account for 6.5 billion individuals globally or 84% of the total world population.…”

Section: Discussionmentioning

confidence: 99%

Current status and barriers in pulmonary hypertension care delivery in India: A qualitative analysis

et al. 2022

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Although pulmonary hypertension (PH) is widely prevalent in India, care delivery for this condition has unique challenges in a lower middle-income country (LMIC). To describe care delivery for patients with PH and associated barriers in India. We interviewed physicians across eight healthcare systems in India about PH clinical care using semi-structured enquiries to understand care delivery and associated challenges in their specific practice as well as the associated health system. Qualitative analysis was performed using content analysis methodology. Physicians reported that common causes for PH in their practice were rheumatic mitral valve disease, coronary artery disease, and congenital heart disease (CHD). No center had a dedicated PH program. Only one center had a specific protocol for PH management. Diagnostic evaluations were limited, and right heart catheterizations were recommended for patients

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“…Hypoxemia exhibits a restrained part in the sensation of panting accomplished by cardiopulmonary diseased patients on the opposite of hypercapnia that generates per se shortness of breath. Individuals with dyspnea are not hypoxemic, but those who have generally experienced a subtle refinement in manifestations after hypoxemia is managed with supplemental oxygen therapy (Harikrishnan et al, 2018). Dyspnea often experiences when the arterial partial pressure of oxygen (PaO 2 ) falls below 40 mmHg.…”

Section: Dyspnea As a Sensationmentioning

confidence: 99%

Happy hypoxemia: A perplexing clinical entity in coronavirus disease 2019

V.¹,

T.²,

M³

et al. 2022

J App Pharm Sci

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The novel pandemic, coronavirus disease 2019 , is a public health exigency of global concern with expanding cases worldwide. Severe acute respiratory syndrome-corona virus-2 is the virus that accounts for COVID-19. The disease manifests with a wide array of symptoms ranging from mild upper respiratory tract infection to severe pneumonia and death. The Happy hypoxemia, synonymously Silent hypoxemia, is described as a clinical entity in individuals with COVID-19, generally expressed as objective hypoxemia lacking respiratory distress symptoms. The condition is characterized by a drop in oxygen saturation and varying arterial blood gas. Intrapulmonary shunting, intravascular microthrombi, loss of lung perfusion control, and impaired diffusion capacity contributes to hypoxemic etiology in COVID-19. The ventilation-perfusion mismatch, covering from shunts to alveolar dead space ventilation, is the principal distinctive feature, suggesting numerous medical goals.

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Pulmonary hypertension registry of Kerala, India (PRO-KERALA) — Clinical characteristics and practice patterns

Cited by 12 publications

References 24 publications

A Study of W.H.O. Group Ii Pulmonary Hypertension by Echocardiography in a Tertiary Care Institute, Tamilnadu, South India

A Study of W.H.O. Group Ii Pulmonary Hypertension by Echocardiography in a Tertiary Care Institute, Tamilnadu, South India

Current status and barriers in pulmonary hypertension care delivery in India: A qualitative analysis

Happy hypoxemia: A perplexing clinical entity in coronavirus disease 2019

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