title: Prevalence, clinical characteristics and outcome of pulmonary hypertension among admitted heart failure patients.
abstract: BACKGROUND
  There is paucity of data in Africa on the prevalence of pulmonary hypertension (PHT) and its impact on morbidity and short-term mortality in heart failure (HF) patients. The aim of this study was to assess the prevalence of PHT, its clinical characteristics and in-hospital mortality among HF patients admitted to a referral hospital in Nigeria.
  
  
  METHODS
  The study was carried out on serially-admitted HF patients who satisfied the inclusion criteria, in a Nigerian tertiary health center. PHT was defined as the presence of mean pulmonary artery pressure (mPAP) of ≥25 mmHg, assessed using Doppler echocardiography and Chemla formula.
  
  
  RESULTS
  A total of 80 admitted HF patients were studied serially. 53 of them (66.25%) had PHT while the remaining 27 (33.75%) had normal mPAP. mPAP was 38.31 ± 12.23 mmHg and 16.39 ± 5.48 mmHg (P < 0.001) for subjects with and without PHT, respectively. The most common cause of HF was hypertensive heart disease (HHD) (28 patients; 35%). Subjects with PHT had relatively lower systolic blood pressure (SBP) (P = 0.044), and larger left atrium (P = 0.036) and left ventricle (LV) at both end-diastole and end-systole (P = 0.036 and P = 0.008, respectively), and a trend toward lower LV ejection fraction (LVEF) (P = 0.053). There was no relationship between mPAP and N-terminal pro-B type natriuretic peptide (P > 0.05). A total of 12 HF patients (15.0%) died, out of whom 8 (66.7%) had PHT. Cardiogenic shock (P = 0.044) and trans-mitral flow velocities ratio (P = 0.023) were the independent determinants of in-hospital mortality.
  
  
  CONCLUSIONS
  PHT was common among the admitted HF patients, and was associated with worse morbidity indices, and a trend toward higher mortality. We recommend that HF patients be screened for PHT, and its presence should be taken into consideration in the management and prognostication of affected patients.
authors.affiliation: Department of Medicine; Bayero University; Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria.
authors.forename: Kamilu M
authors.initials: KM
authors.lastname: Karaye
authors.forename: Hadiza
authors.initials: H
authors.lastname: Saidu
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Bala
authors.forename: Isa A
authors.initials: IA
authors.lastname: Yahaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality*; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D015995:Prevalence; D011446:Prospective Studies; D015996:Survival Rate; D016277:Ventricular Function, Left; D055815:Young Adult