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. 2023 Oct 5;101(10):751-755.

Hemodynamic profile of pulmonary arterial hypertension in a Tunisian center

Amira Jamoussi  1 , Nacef Ben Mrad  1 , Emna Rachdi  1 , Fatma Jarraya  1 , Sarra Zairi  2 , Kais Ben Romdhane  1 , Mohamed Besbes  1 , Samia Ayed  1 , Jalila Ben Khelil  1
Affiliations

Hemodynamic profile of pulmonary arterial hypertension in a Tunisian center

Amira Jamoussi et al. Tunis Med. .

Abstract

Introduction: Pulmonary hypertension (PH) management can only be conceived in a specialized center. We aimed to report the experience of a Tunisian ICU about PH invasive hemodynamic exploration and to describe consequent therapeutic decisions.

Methods: Retrospective descriptive study including all patients admitted to the medical ICU of Abderrahmen Mami Hospital for right heart catheterization (RHC), between 2005 and 2019 as part of the investigation of PH. Patients' characteristics, procedure safety and arising therapeutic decisions were then reported.

Results: Forty patients were admitted for hemodynamic evaluation. RHC confirmed PH in 31 patients and exploration was then completed with NO reactivity test. Mean age was 41.3±15 years, gender ratio M/F was 1.06. PH was classified into: group 1 (n=13), group 2 (n=14), group 4 (n=2) and group 5 (n=2). NO vasoreactivity test was positive in 50% of post-capillary PH and in 28% of pre-capillary PH. The therapeutic decision following the reversibility test was: prescription of calcium channel blockers (n=5), a specific pulmonary vasodilator (n=10), operability (n=6), heart-lung transplant (n=3) and therapeutic abstention (n=7). Two minor complications were reported.

Conclusion: The medical ICU in Abderrahmen Mami Hospital represents an experienced team in hemodynamic investigations despite low annual RHC number. NO reactivity test is an indispensable tool that enables important decisions during PH management.

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Figures

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Figure 1. Puncture of the right jugular vein
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Figure 2. Wedge PAOP indicating catheter positioning in the pulmonary artery
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Figure 3. Chest X-ray imaging showing Swan Ganz introduced through right jugular vein (red arrow) with distal tip positioned in the right pulmonary artery (yellow arrow)
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Figure 4. Inclusion flowchart
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Figure 5. Patients’ classification according to ESC guidelines
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Figure 6. Reversibility according to PAH type
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See this image and copyright information in PMC

References

    1. Hoeper MM, Humbert M, Souza R, Idrees M, Kawut SM, Sliwa-Hahnle K, et al. A global view of pulmonary hypertension. Lancet Respir Med. 2016;4:306–322. - PubMed
    1. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. ESC Scientific Document Group. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT) Eur Heart J. 2016;37:67–119. - PubMed
    1. Ben Abdelaziz A, Ben Hassine D, Chebil D, Nouira S, Ben Abdelaziz A, Melki S, Barhoumi T, Ben Salem K. Descriptive Statistics in Health Sciences. Tunis Med. 2021 DéCembre;99(12):1117–1125. English. - PMC - PubMed
    1. Elshazly M, Mostafa AI, Ibrahim A, Sabry IM. Assessing the spectrum of pulmonary hypertension identified at an Egyptian expert referral center. Egypt J Bronchol. 2021;15:48.
    1. Hurdman J, Condliffe R, Elliot CA, Davies C, Hill C, Wild JM, Capener D, et al. ASPIRE registry: Assessing the spectrum of pulmonary hypertension identified at a referral centre. Eur Respir J. 2012;39:945–955. - PubMed

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