Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar

Background: Pulmonary artery hypertension (PAH) is a progressive disease with high mortality. Major advances had been made in the treatment of this condition during the last decade. Aim: To characterize the clinical evolution and mortality of a cohort of Chilean patients. Material and Methods: Seven...

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Autores principales:	Enríquez,Andrés, Castro,Pablo, Sepúlveda,Pablo, Verdejo,Hugo, Greig,Douglas, Gabrielli,Luigi, Ferrada,Marcela, Lapostol,Carolina
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2011
Materias:	Drug therapy Hypertension pulmonary Survival rate
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300007
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spelling	oai:scielo:S0034-988720110003000072011-08-25Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonarEnríquez,AndrésCastro,PabloSepúlveda,PabloVerdejo,HugoGreig,DouglasGabrielli,LuigiFerrada,MarcelaLapostol,Carolina Drug therapy Hypertension pulmonary Survival rate Background: Pulmonary artery hypertension (PAH) is a progressive disease with high mortality. Major advances had been made in the treatment of this condition during the last decade. Aim: To characterize the clinical evolution and mortality of a cohort of Chilean patients. Material and Methods: Seventeen patients with PAH diagnosed in the last 10 years in two Chilean hospitals were enrolled. Measurements at diagnosis included hemodynamic variables and 6-minute walk test. The patients were followed clinically for 3 years and the observed mortality was compared with that predicted by the prognostic equation proposed by the historic registry of the National Institutes of Health (NIH). Results: The mean age of patients was 45 years and 80% had an idiopathic PAH. The mean median pulmonary artery pressure was 57 ± 15 mmHg, the cardiac index was 2.4 ± 0.7 l/min/m² and the right atrial pressure was 12 ± 8 mmHg. The 6-minute walk distance was 348 ± 98 m. All patients received anticoagulants. Eighty two percent received ambrisentan, 12% received bosentan, 29% received iloprost and 24% sildenafil. At the end of follow-up only 3 patients had died, with an observed survival rate of88, 82 and 82% at 1, 2 and 3 years, respectively. In contrast, the survival calculated according to the predictive formula of the NIH was 67, 56 and 45%, respectively. Among surviving patients, an improvement in exercise capacity was observed after one year (p < 0.05). Conclusions: The observed survival rate was significantly better than that estimated according to historical data. Furthermore, therapy was associated with an improvement in functional capacity after one year. This prognostic improvement is consistent with data of other contemporary registries published after the NIH Registry.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.139 n.3 20112011-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300007es10.4067/S0034-98872011000300007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Drug therapy Hypertension pulmonary Survival rate
spellingShingle	Drug therapy Hypertension pulmonary Survival rate Enríquez,Andrés Castro,Pablo Sepúlveda,Pablo Verdejo,Hugo Greig,Douglas Gabrielli,Luigi Ferrada,Marcela Lapostol,Carolina Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
description	Background: Pulmonary artery hypertension (PAH) is a progressive disease with high mortality. Major advances had been made in the treatment of this condition during the last decade. Aim: To characterize the clinical evolution and mortality of a cohort of Chilean patients. Material and Methods: Seventeen patients with PAH diagnosed in the last 10 years in two Chilean hospitals were enrolled. Measurements at diagnosis included hemodynamic variables and 6-minute walk test. The patients were followed clinically for 3 years and the observed mortality was compared with that predicted by the prognostic equation proposed by the historic registry of the National Institutes of Health (NIH). Results: The mean age of patients was 45 years and 80% had an idiopathic PAH. The mean median pulmonary artery pressure was 57 ± 15 mmHg, the cardiac index was 2.4 ± 0.7 l/min/m² and the right atrial pressure was 12 ± 8 mmHg. The 6-minute walk distance was 348 ± 98 m. All patients received anticoagulants. Eighty two percent received ambrisentan, 12% received bosentan, 29% received iloprost and 24% sildenafil. At the end of follow-up only 3 patients had died, with an observed survival rate of88, 82 and 82% at 1, 2 and 3 years, respectively. In contrast, the survival calculated according to the predictive formula of the NIH was 67, 56 and 45%, respectively. Among surviving patients, an improvement in exercise capacity was observed after one year (p < 0.05). Conclusions: The observed survival rate was significantly better than that estimated according to historical data. Furthermore, therapy was associated with an improvement in functional capacity after one year. This prognostic improvement is consistent with data of other contemporary registries published after the NIH Registry.
author	Enríquez,Andrés Castro,Pablo Sepúlveda,Pablo Verdejo,Hugo Greig,Douglas Gabrielli,Luigi Ferrada,Marcela Lapostol,Carolina
author_facet	Enríquez,Andrés Castro,Pablo Sepúlveda,Pablo Verdejo,Hugo Greig,Douglas Gabrielli,Luigi Ferrada,Marcela Lapostol,Carolina
author_sort	Enríquez,Andrés
title	Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
title_short	Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
title_full	Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
title_fullStr	Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
title_full_unstemmed	Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
title_sort	cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar
publisher	Sociedad Médica de Santiago
publishDate	2011
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300007
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Cambios en el pronóstico a largo plazo de la hipertensión arterial pulmonar

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