Primary pulmonary hypertension in cirrhosis of liver.
BACKGROUND
Primary pulmonary hypertension (PPH) is a grave association of portal hypertension, and is potentially fatal in liver transplant candidates.


OBJECTIVE
To investigate the prevalence of PPH among cirrhotics with portal hypertension.


METHODS
43 cirrhotics with portal hypertension (Child B 22, C 14), after screening for cardiopulmonary diseases, were evaluated by hemodynamic study.


RESULTS
PPH was detected in 2 cases (4.7%), both in Child B, hepatitis B and C viruses being the etiologies. Neither had portal axis thrombosis. Two other cases also had pulmonary hypertension, but with high pulmonary capillary wedge pressure (PCWP). The 41 cases without and 2 cases with PPH had, respectively, mean pulmonary artery pressure (MPAP) 16.3 (5.9) mmHg, 26 mmHg and 33 mmHg; PCWP 11.5 (6.7) mmHg, 12 mmHg and 11 mmHg; transpulmonary pressure gradient 4.8 (2.6) mmHg (n = 27), 14 mmHg and 22 mmHg; and pulmonary vascular resistance 80.2 (55.8) dyne.sec.cm-5 (n = 27), 155.6 dyne.sec.cm-5 and 366.7 dyne.sec.cm-5. No correlation of MPAP was found with either Child-Pugh scoring (r2 = 0.0347) or with hepatic venous pressure gradient (r2 = 0.0021).


CONCLUSIONS
PPH has a prevalence of 4.7% among cirrhotics with portal hypertension; it bears no relation with severity of liver disease.
Sen
S
S
Department of Medicine, Institute of Post Graduate Medical Education and Research, Calcutta.
Biswas
P K
PK
Biswas
J
J
Das
T K
TK
De
B K
BK
D000328:Adult; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure