Pulmonary Vascular Disease |

Treatment of Pulmonary Arterial Hypertension in a Tertiary Setting FREE TO VIEW

Anish Sachdev*, MBBS; Dimitar Sajkov, MBBS; Robert Minson, MBBS
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Flinders Medical Centre, Adelaide, SA, Australia

Chest. 2012;142(4_MeetingAbstracts):815A. doi:10.1378/chest.1373717
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SESSION TYPE: DVT/PE/Pulmonary Hypertension Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary arterial hypertension (PAH) is an under-recognized but important cause of dyspnea, associated with significant morbidity and mortality. Diagnosis is based on history, examination, Doppler echocardiography and confirmed with right heart catheterization (RHC). The six-minute walk test (6MWT) and pulmonary artery pressures are often used to monitor the progress of PAH and response to treatment. Here we report the results of the recent audit of PAH diagnostic and management practices at Flinders Medical Centre (FMC) in South Australia with particular emphasis on the impact of various agents on pulmonary artery pressure and 6MWT distance.

METHODS: This audit included 29 patients currently managed in the pulmonary hypertension clinic at FMC. The patients were identified from the database and their medical records were reviewed for information regarding demographics, cause of pulmonary hypertension, pharmacological agent prescribed, Doppler echocardiographic estimate of the systolic PAP, 6MWT distance and dyspnea score before and after 6 months of treatment. The results were analyzed using paired t-test.

RESULTS: Idiopathic PAH was the most common cause (72%) of PAH in our population. The mean PAP obtained from RHC at diagnosis was 42.8 mmHg (95% CI 37.45 - 48.89). Over half of our patients (58%) received endothelin receptor antagonist. Following six months of treatment there was a mean drop in PAP of 5.2 mmHg (95% CI 0.05 - 10.30; p=-0.048), associated with a mean gain in 6MWT distance of 50.1 m (95% CI 18.15-82.09; p=0.003). Overall, eight of the 29 patients had a change in WHO functional class.

CONCLUSIONS: Endothelin receptor antagonists were the predominant medication class prescribed in our PAH patients. Treatment of PAH in our population resulted in a modest, but significant decline of PAP. This translated into a small, but significant increase in exercise endurance. Our results are in keeping with previously published data.

CLINICAL IMPLICATIONS: Pharmacological agents prescribed in patients with PAH are associated with a trend towards improvement in endurance and reduction of mean PAP parameters.

DISCLOSURE: The following authors have nothing to disclose: Anish Sachdev, Dimitar Sajkov, Robert Minson

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Flinders Medical Centre, Adelaide, SA, Australia




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