Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades

Objective: to perform a comprehensive analysis of the clinical, functional and hemodynamic status of patients with idiopathic pulmonary hypertension (IPAH) to compare the "portrait" of historical and modern subgroups.   Materials and methods. The study included 120 patients with IPAH obser...

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Main Authors: A. M. Shariya, T. V. Martynyuk
Format: Article
Language:Russian
Published: InterMedservice 2024-10-01
Series:Евразийский Кардиологический Журнал
Subjects:
Online Access:https://www.heartj.asia/jour/article/view/6475
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author A. M. Shariya
T. V. Martynyuk
author_facet A. M. Shariya
T. V. Martynyuk
author_sort A. M. Shariya
collection DOAJ
description Objective: to perform a comprehensive analysis of the clinical, functional and hemodynamic status of patients with idiopathic pulmonary hypertension (IPAH) to compare the "portrait" of historical and modern subgroups.   Materials and methods. The study included 120 patients with IPAH observed in the Department of Pulmonary Hypertension and Heart Diseases, E.I. Chazov National Medical Research Center of Cardiology. The pts were divided into 2 subgroups depending on the time of diagnosis and were comparable in terms of the initial functional class (WHO). A comparative analysis of clinical, functional, and hemodynamic parameters was carried out. The diagnosis was established according to the algorithm of the Eurasian (2019) and Russian guidelines for the diagnosis and treatment of pulmonary hypertension (PH) (2020).   Results. The median time from the onset of PH symptoms to diagnosis in the historical and modern cohorts was 24 months and 13.5 months, respectively, and from the first visit to the diagnosis of IPAH – 13 months and 3.5 months. The median age of patients was 31 years and 40.5 years. In both subgroups, the number of women dominated – up to 86.6 % of patients in the modern cohort. Clinical, laboratory, functional and instrumental tests did not differ significantly between the subgroups. In the structure of concomitant pathology, comorbidity with cardiovascular pathology is most common, in a larger percentage in the modern cohort of patients: hypertension – up to 31.6 %, obesity – up to 25 % and diabetes mellitus – up to 5 %. According to various risk assessment scales, most patients in both subgroups demonstrated intermediate risk at the time of diagnosis, but in the modern cohort, a large proportion of high-risk patients was noted (20.0 %).   Conclusion. Nowadays, IPAH remains a late-diagnosed disease, which contributes to a later treatment prescription. The clinical "portrait" of patients with IPAH has changed over the years towards older and more comorbid patients, especially with cardiovascular diseases. Timely detection and treatment of concomitant pathology, timely risk assessment are the key to prescribing the most effective treatment regimens, improving the quality of life and prognosis of patients with IPAH.
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spelling doaj-art-74b66d22f00148ca841fc40e3ffe51e52025-08-03T13:28:57ZrusInterMedserviceЕвразийский Кардиологический Журнал2225-16852305-07482024-10-0103424910.38109/2225-1685-2024-3-42-496351Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decadesA. M. Shariya0T. V. Martynyuk1E.I. Chazov National Medical Research Center of CardiologyE.I. Chazov National Medical Research Center of Cardiology; N.I. Pirogov Russian National Research Medical UniversityObjective: to perform a comprehensive analysis of the clinical, functional and hemodynamic status of patients with idiopathic pulmonary hypertension (IPAH) to compare the "portrait" of historical and modern subgroups.   Materials and methods. The study included 120 patients with IPAH observed in the Department of Pulmonary Hypertension and Heart Diseases, E.I. Chazov National Medical Research Center of Cardiology. The pts were divided into 2 subgroups depending on the time of diagnosis and were comparable in terms of the initial functional class (WHO). A comparative analysis of clinical, functional, and hemodynamic parameters was carried out. The diagnosis was established according to the algorithm of the Eurasian (2019) and Russian guidelines for the diagnosis and treatment of pulmonary hypertension (PH) (2020).   Results. The median time from the onset of PH symptoms to diagnosis in the historical and modern cohorts was 24 months and 13.5 months, respectively, and from the first visit to the diagnosis of IPAH – 13 months and 3.5 months. The median age of patients was 31 years and 40.5 years. In both subgroups, the number of women dominated – up to 86.6 % of patients in the modern cohort. Clinical, laboratory, functional and instrumental tests did not differ significantly between the subgroups. In the structure of concomitant pathology, comorbidity with cardiovascular pathology is most common, in a larger percentage in the modern cohort of patients: hypertension – up to 31.6 %, obesity – up to 25 % and diabetes mellitus – up to 5 %. According to various risk assessment scales, most patients in both subgroups demonstrated intermediate risk at the time of diagnosis, but in the modern cohort, a large proportion of high-risk patients was noted (20.0 %).   Conclusion. Nowadays, IPAH remains a late-diagnosed disease, which contributes to a later treatment prescription. The clinical "portrait" of patients with IPAH has changed over the years towards older and more comorbid patients, especially with cardiovascular diseases. Timely detection and treatment of concomitant pathology, timely risk assessment are the key to prescribing the most effective treatment regimens, improving the quality of life and prognosis of patients with IPAH.https://www.heartj.asia/jour/article/view/6475pulmonary arterial hypertensionidiopathic pulmonary arterial hypertensionrisk assessmentprognosismortality riskorphan diseases
spellingShingle A. M. Shariya
T. V. Martynyuk
Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
Евразийский Кардиологический Журнал
pulmonary arterial hypertension
idiopathic pulmonary arterial hypertension
risk assessment
prognosis
mortality risk
orphan diseases
title Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
title_full Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
title_fullStr Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
title_full_unstemmed Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
title_short Changing “portrait” of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
title_sort changing portrait of patients with newly diagnosed idiopathic pulmonary hypertension over the past two decades
topic pulmonary arterial hypertension
idiopathic pulmonary arterial hypertension
risk assessment
prognosis
mortality risk
orphan diseases
url https://www.heartj.asia/jour/article/view/6475
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