Etiological frequency of pulmonary hypertension in a reference outpatient clinic in Bahia, Brazil.
BACKGROUND
Pulmonary hypertension (PH) results from several etiologies, with possible geographic influences; however, few studies have described the etiological frequency of PH, especially in our country. It is not clear whether there is an association between etiology and pulmonary pressure level or symptom intensity.


OBJECTIVE
1) to describe the etiological prevalence of PH in the state of Bahia, Brazil; 2) to evaluate whether the etiology is a determinant factor for the pulmonary pressure level; 3) to evaluate whether the etiology is a determinant factor for functional class; 4) to identify the other predictors of pulmonary pressure level and functional class.


METHODS
The present was an observational, cross-sectional study that analyzed individuals with PH treated at the Magalhaes Neto Outpatient Clinic, between June 2005 and December 2007. PH was defined as pulmonary artery systolic pressure (PASP) > 40 mmHg measure at the echocardiogram. Patients with chronic obstructive pulmonary disease or ventricular disease were excluded from the study.


RESULTS
A total of 48 patients with PASP = 86 +/- 24 mmHg were studied. Regarding the etiology, 42% of the patients were classified as idiopathic, followed by 25% as schistosomatic, 19% as congenital cardiopathy and 10% of chronic pulmonary embolism. A longer time of disease predicted higher pressures in patients with cardiopathy. Individuals with schistosomiasis had the best functional performance when compared to the others (456 +/- 58 vs. 299 +/- 138 meters, p=0.005). The schistosomatic etiology and younger age presented better functional class.


CONCLUSIONS
1) the idiopathic classification is the most prevalent, with schistosomiasis being the most frequent specific cause in our country; 2) patients with schistosomatic etiology and of younger age present better functional class. 3) the congenital cardiopathy results in a higher pressure level in the pulmonary artery, probably due to the longer duration of the disease.
Machado
Cesar
C
Fundação Bahiana para o Desenvolvimento das Ciências, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil. cgmmachado@yahoo.com
Brito
Isis
I
Souza
Denile
D
Correia
Luis Cláudio
LC
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D012552:Schistosomiasis / Q000150:complications* / Q000453:epidemiology; D012720:Severity of Illness Index