João Arthur Pazello et al. Ana Cristina Camarozano
Abstract
Introduction
Pulmonary hypertension is potentially fatal and courses with important day-to-day 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. (Arq Bras Cardiol: Imagem cardiovasc. 2018;31(3):175-182)