Registry of cases of pulmonary hypertension in army hospitals

Background
Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation, which results, over time, from extensive vascular remodeling and increased pulmonary vascular resistance. Registries conducted since the National Institutes of Health study have enhanced our understanding of select aspects of pulmonary arterial hypertension (PAH). A network of 17 French university hospitals reported observations from a registry of 674 adults with PAH and described the minimum prevalence and incidence, as well as the clinical and hemodynamic characteristics, of this group.


Objective
To record all the cases of PH in all Egyptian army hospitals in the period between January 2015 and December 2019.


Patients and methods
This study was conducted on 150 patients with PH. They were recruited from the outpatient clinic and Department of Chest at specialized hospitals of Kobry Elkobba Armed Forces, as well as Air Force specialized and international medical center of the armed forces. This study was carried out on all patients diagnosed as having PH, as a retrospective and prospective study, starting from January 2015 till December 2019. The patients were subjected to the diagnostic algorithm of PH suggested by the 2015 European Cardiology Society/European Respiratory Society guidelines for the diagnosis and treatment of PH.


Results
The study was conducted on 150 patients with PH, including group 1 [88 (58.6%) patients], group 2 [16 (10.6%) patients], group 3 [eight (5.3%) patients], group 4 [34 (22.6%) patients], and group 5 [four (2.6%) patients], and there were seven patients of multigroups. The detailed data of different therapies were shown as important numbers. The diuretic therapies were given to 120 patients, 12 patients were on oxygen therapy, calcium channel blockers were only given to the five vasoreactive patients in our study, and 34 patients received oral anticoagulant, whereas specific drugs were given to 93 patients.


Conclusion
This was a preliminary study establishing patient characteristics in Egypt in the form of a registry. The most frequent PH etiologies were PAH and chronic thromboembolic PH, and patients were substantially younger at diagnosis compared with other international cohorts. Most patients with PAH received targeted therapy and showed significant improvement in disease severity (WHO Function Class). One of the most important limitation was the lack of the of the follow-up and survival data of many patients; however, many patients who were in the follow-up programs made a great survival but not to count on it as a result in the registry.