DOI: https://doi.org/10.36347/sasjm.2024.v10i10.030

Pages: 1136-1142

Pulmonary hypertension is a common complication of severe respiratory diseases, the prevalence of which remains unknown. The objective of the study is to determine the clinical, functional, etiological and evolutionary profile of patients followed for HTP associated with respiratory diseases. We report a retrospective study of 86 patients. The average age was 56 ± 8.2 years with male predominance of 62%. The most common underlying chronic respiratory pathology was COPD (46%). The main symptom was dyspnea. The majority of COPD patients (66%) had moderate to severe irreversible obstructive airway disease with a median FEV1 of 54% of theoretical and severe impairment of the alveolar-capillary diffusion capacity of CO (DLCO). Cardiac ultrasound revealed pulmonary hypertension with mean PAPS of 61mmHg. The mean value of the measured IT Vmax was 3.4 m/s. Pulmonary hypertension was more common in patients monitored for COPD groups C and D of the GOLD classification (p = 0.01). It was correlated with the severity of dyspnea according to the NYHA (r = 0.27). There was no correlation between the FEV1 value, the PaO2 value and the severity of PH. No correlation was found between the PAPS and the distance traveled during the 6MWT. Patients with severe HTP had more severe exacerbations requiring more frequent hospitalizations (p = 0.003) and a more severe BODE index (p = 0.002). Therapeutic management was based mainly on optimization of background treatment of the underlying respiratory disease, oxygen therapy and diuretics in case of right heart failure. The clinical course was marked by improvement of dyspnea and hypoxia in 68% of cases, twenty-four percent of patients had clinical and functional worsening. We deplore the death of eight patients following a severe exacerbation.