Demographic and clinical characteristics of pulmonary arterial hypertension caused by schistosomiasis are indistinguishable from other etiologies

Abstract INTRODUCTION: Pulmonary arterial hypertension (PAH) is a serious pulmonary circulation disease caused by several etiologies, including schistosomiasis. The present study retrospectively evaluated the clinical and hemodynamic characteristics of patients with schistosomal PAH (PAH-Sch) compared to those of non-Sch PAH patients (non-Sch PAH). METHODS: Patients treated at the Pronto-Socorro Cardiológico de Pernambuco and diagnosed by right cardiac catheterization were divided into PAH-Sch and non-Sch PAH groups. Their socio-demographic and clinical characteristics, N-terminal-pro B-type natriuretic peptide (NT-proBNP), and echocardiography and hemodynamic parameters were retrospectively reviewed. RESULTS: Among the included 98 patients (mean age, 45 ± 14 years; 68 women [69.4%]), we found 56 PAH-Sch and 42 non-Sch PAH. The age distribution was heterogeneous in the PAH-Sch group, with patients predominantly ranging from 50-59 (p <0.004). Dyspnea was the most common symptom, reported by 92 patients (93.8%), and commonly present for over two years prior to diagnosis. Clinical symptoms were similar in both groups, with no differences in functional class, pulmonary artery systolic pressure (p = 0.102), 6-minute walk test score (p = 0.234), NT-proBNP serum levels (p = 0.081), or hemodynamic parameters. CONCLUSIONS: Patients with PAH-Sch present clinical, laboratory, and hemodynamic profiles similar to those with PAH resulting from other etiologies of poor prognosis. PAH is an important manifestation of schistosomiasis in endemic regions that is often diagnosed late.

引言：肺动脉高压（Pulmonary arterial hypertension, PAH）是一类由多种病因引发的严重肺循环疾病，血吸虫病即为其中之一。本研究回顾性对比分析了血吸虫病相关性肺动脉高压（PAH-Sch）患者与非血吸虫病相关性肺动脉高压（non-Sch PAH）患者的临床及血流动力学特征。研究方法：于伯南布哥心血管急救中心（Pronto-Socorro Cardiológico de Pernambuco）接受治疗并经右心导管确诊的患者被划分为PAH-Sch组与non-Sch PAH组。研究人员对两组患者的社会人口学特征、临床特征、N末端B型利钠肽原（N-terminal-pro B-type natriuretic peptide, NT-proBNP）、超声心动图指标及血流动力学参数进行了回顾性梳理与分析。研究结果：本次研究共纳入98例患者，平均年龄为45±14岁，其中女性68例（占比69.4%）；PAH-Sch组56例，non-Sch PAH组42例。PAH-Sch组的年龄分布异质性显著，患者主要集中于50~59岁年龄段（p<0.004）。呼吸困难为最常见症状，共计92例患者（93.8%）出现该症状，且多数患者在确诊前症状已持续超过2年。两组患者的临床症状无明显差异，在功能分级、肺动脉收缩压（p=0.102）、6分钟步行试验得分（p=0.234）、血清NT-proBNP水平（p=0.081）及血流动力学参数方面均未观察到统计学差异。研究结论：PAH-Sch患者的临床、实验室检测及血流动力学特征与其他病因所致预后不良的PAH患者高度相似。在血吸虫病流行区域，PAH是血吸虫病的重要临床表现之一，且该疾病往往确诊较晚。