A STUDY OF W.H.O. GROUP II PULMONARY HYPERTENSION BY ECHOCARDIOGRAPHY IN A TERTIARY CARE INSTITUTE, TAMILNADU, SOUTH INDIA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 40
Abstract
BACKGROUND Pulmonary hypertension is a progressive disease with high morbidity and mortality. The W.H.O. Group II Pulmonary hypertension (Pulmonary hypertension due to left heart disease) is the most prevalent form of PHT worldwide. There is paucity of data regarding Group II Pulmonary hypertension from developing countries including India. This retrospective descriptive study was carried out at a tertiary care institute with an objective of establishing the epidemiological data of Group II Pulmonary hypertension by Echocardiography. MATERIALS AND METHODS All patients who were referred for the first time echo between January 2016 and December 2016 were included and analysed in this study. Echocardiogram was performed by consultant cardiologist using Philips HD11XE and ALOKA SSD-4000 echo machines following ASE Guidelines. Pulmonary artery systolic pressure was derived from tricuspid regurgitation jet velocity by modified Bernoulli equation with the addition of estimated right atrial pressure. The standard echo doppler techniques were applied to diagnose the presence of left sided valvular diseases and left ventricular dysfunction by following ASE guidelines. RESULTS In our study of 17,625 cases, 282 (16%) patients were diagnosed as pulmonary hypertension. The WHO Group II pulmonary hypertension (pulmonary hypertension caused by left heart disease) is the commonest echo group (72.7%) present in our study. Among the patients with Group II pulmonary hypertension 51.71% had rheumatic left sided valvular heart disease and 48.29% had LV dysfunction due to CAD and cardiomyopathy. RHD was more common in female (71.70%) while LV dysfunction was more common in male (67.68%). The mean age Group in our study was 35-45 years. Patients with combined mitral stenosis and mitral regurgitation (42.45%) commonly presented with significant pulmonary hypertension. Among the Group II PHT patients with LV dysfunction, 80.81% had LV systolic dysfunction with reduced ejection fraction and 19.91% had LV diastolic dysfunction with normal EF. The functional mitral regurgitation was present in 67.68% of patients with LV systolic dysfunction. CONCLUSION The Group II pulmonary hypertension (PHT due to left heart disease) is the leading cause of pulmonary hypertension. The rheumatic left sided valvular heart disease and LV dysfunction due to CAD and cardiomyopathy are the major causes of Group II pulmonary hypertension. The early diagnosis of the underlying left heart disease by echocardiography and its timely correction may improve the survival of the patients with Group II pulmonary hypertension.
Authors and Affiliations
Anandh Govindharaju, Senthilkumar Gopalakrishnan
Keywords
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- EP ID EP575541
- DOI 10.18410/jebmh/2018/582
- Views 102
- Downloads 0
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