Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil
ABSTRACT Data about pulmonary arterial hypertension (PAH) patients living in low‐ and middle‐income countries remain scarce. This study assessed prognostic factors associated with time to clinical worsening (CW) or death of a cohort of PAH patients in Minas Gerais, Brazil. This retrospective cohort...
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Wiley
2025-04-01
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| Series: | Pulmonary Circulation |
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| Online Access: | https://doi.org/10.1002/pul2.70086 |
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| author | Ricardo Amorim Correa Camila Farnese Rezende Eliane Viana Mancuzo Claudia Mickael Camila M. C. Loureiro Rudolf K. F. Oliveira Joan F. Hilton Brian B. Graham |
| author_facet | Ricardo Amorim Correa Camila Farnese Rezende Eliane Viana Mancuzo Claudia Mickael Camila M. C. Loureiro Rudolf K. F. Oliveira Joan F. Hilton Brian B. Graham |
| author_sort | Ricardo Amorim Correa |
| collection | DOAJ |
| description | ABSTRACT Data about pulmonary arterial hypertension (PAH) patients living in low‐ and middle‐income countries remain scarce. This study assessed prognostic factors associated with time to clinical worsening (CW) or death of a cohort of PAH patients in Minas Gerais, Brazil. This retrospective cohort study describes baseline clinical variables by PAH etiology and estimates time from diagnosis to CW [all‐cause death, any‐cause hospitalization, or disease progression (decrease of ≥ 15% in 6MWD and need for additional PAH therapy or worsening of functional class (FC)] and time to death. 79 out of 102 participants developed CW and 38 died while under follow‐up. The most prevalent etiologies were PAH associated with schistosomiasis (PAH‐Sch), idiopathic (IPAH), with congenital heart disease (PAH‐CHD), and with connective tissue disease (PAH‐CTD). The overall median event‐free time to CW was 3.3 (95% CI, 2.3–4.6) years, which was similar across etiologies (log‐rank test: p = 0.12). WHO FC III‐IV, DLCO < 70%, heart rate recovery in 1 min after the 6‐min walk test (HRR1) < 18 beats/minute, and baseline mPAP ≥ 50 mmHg were predictive of CW‐free time. The median time to all‐cause mortality was 10.2 (95% CI, 6.8 – > 10) years and varied among etiologies (log‐rank test: p < 0.001). Time to CW was statistically independent of PAH etiology but depended on baseline WHO FC, DLCO, HRR, and mPAP. After CW events, PAH‐Sch and PAH‐CTD survived less on average than IPAH and PAH‐CHD participants. |
| format | Article |
| id | doaj-art-e72b40297d0242fc9479c08445cf748c |
| institution | Kabale University |
| issn | 2045-8940 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj-art-e72b40297d0242fc9479c08445cf748c2025-08-20T03:29:15ZengWileyPulmonary Circulation2045-89402025-04-01152n/an/a10.1002/pul2.70086Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of BrazilRicardo Amorim Correa0Camila Farnese Rezende1Eliane Viana Mancuzo2Claudia Mickael3Camila M. C. Loureiro4Rudolf K. F. Oliveira5Joan F. Hilton6Brian B. Graham7Medical School, Hospital das Clínicas, Pulmonary Vascular Diseases Section Federal University of Minas Gerais Belo Horizonte Minas Gerais BrazilHospital das Clínicas Federal University of Minas Gerais, Pulmonary Vascular Diseases Section Belo Horizonte Minas Gerais BrazilMedical School, Hospital das Clínicas, Pulmonary Vascular Diseases Section Federal University of Minas Gerais Belo Horizonte Minas Gerais BrazilPulmonary and Critical Care Medicine University of Colorado Anschutz Medical, Campus Aurora Colorado USAPulmonary Medicine Santa Casa Hospital Salvador Bahia BrazilDepartment of Medicine, Division of Respiratory Diseases Federal University of São Paulo São Paulo BrazilDepartment of Epidemiology and Biostatistics University of California San Francisco San Francisco California USADepartment of Medicine, Division of Pulmonary and Critical Care Medicine University of California San Francisco San Francisco California USAABSTRACT Data about pulmonary arterial hypertension (PAH) patients living in low‐ and middle‐income countries remain scarce. This study assessed prognostic factors associated with time to clinical worsening (CW) or death of a cohort of PAH patients in Minas Gerais, Brazil. This retrospective cohort study describes baseline clinical variables by PAH etiology and estimates time from diagnosis to CW [all‐cause death, any‐cause hospitalization, or disease progression (decrease of ≥ 15% in 6MWD and need for additional PAH therapy or worsening of functional class (FC)] and time to death. 79 out of 102 participants developed CW and 38 died while under follow‐up. The most prevalent etiologies were PAH associated with schistosomiasis (PAH‐Sch), idiopathic (IPAH), with congenital heart disease (PAH‐CHD), and with connective tissue disease (PAH‐CTD). The overall median event‐free time to CW was 3.3 (95% CI, 2.3–4.6) years, which was similar across etiologies (log‐rank test: p = 0.12). WHO FC III‐IV, DLCO < 70%, heart rate recovery in 1 min after the 6‐min walk test (HRR1) < 18 beats/minute, and baseline mPAP ≥ 50 mmHg were predictive of CW‐free time. The median time to all‐cause mortality was 10.2 (95% CI, 6.8 – > 10) years and varied among etiologies (log‐rank test: p < 0.001). Time to CW was statistically independent of PAH etiology but depended on baseline WHO FC, DLCO, HRR, and mPAP. After CW events, PAH‐Sch and PAH‐CTD survived less on average than IPAH and PAH‐CHD participants.https://doi.org/10.1002/pul2.70086pulmonary arterial hypertensionrisk factorsschistosomiasissurvival |
| spellingShingle | Ricardo Amorim Correa Camila Farnese Rezende Eliane Viana Mancuzo Claudia Mickael Camila M. C. Loureiro Rudolf K. F. Oliveira Joan F. Hilton Brian B. Graham Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil Pulmonary Circulation pulmonary arterial hypertension risk factors schistosomiasis survival |
| title | Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil |
| title_full | Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil |
| title_fullStr | Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil |
| title_full_unstemmed | Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil |
| title_short | Morbidity and Mortality Associated With Pulmonary Arterial Hypertension in a Schistosomiasis‐Endemic Region of Brazil |
| title_sort | morbidity and mortality associated with pulmonary arterial hypertension in a schistosomiasis endemic region of brazil |
| topic | pulmonary arterial hypertension risk factors schistosomiasis survival |
| url | https://doi.org/10.1002/pul2.70086 |
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