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Predicting pulmonary hypertension and outcomes in patients with left heart disease
Includes bibliographical references
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| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Medicine
2016
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| _version_ | 1867613182514692096 |
|---|---|
| access_status_str | Open Access |
| author | Dzudie Tamdja, Anastase Innocent |
| author2 | Sliwa-Hahnle, Karen |
| author_browse | Dzudie Tamdja, Anastase Innocent Sliwa-Hahnle, Karen |
| author_facet | Sliwa-Hahnle, Karen Dzudie Tamdja, Anastase Innocent |
| author_sort | Dzudie Tamdja, Anastase Innocent |
| collection | Thesis |
| description | Includes bibliographical references |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/16533 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:05.102Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2016 |
| publishDateRange | 2016 |
| publishDateSort | 2016 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/16533 Predicting pulmonary hypertension and outcomes in patients with left heart disease Dzudie Tamdja, Anastase Innocent Sliwa-Hahnle, Karen Kengne, André Pascal Medicine Pulmonary hypertension Includes bibliographical references Pulmonary hypertension (PH) is defined as a rise in the pressure in the pulmonary arteries resulting from a variety of diseases including chronic infectious diseases, lung diseases and left heart diseases (LHD). It is a global health problem and accounts for a substantial portion of cardiovascular disease. PH due to LHD (PH-LHD) is credited to be the most common form of PH worldwide and is associated with adverse outcomes. Considering the suggestions of high prevalence and potential adverse outcomes of PH in sub-Saharan Africa (SSA), the investigation of the etiologies, clinical profile, correlates, and outcomes of PH-LHD in this region is a medical priority. Methods: Through a systematic review, we assessed existing evidence on the predictors of PH-LHD outcomes. Then, through two prospective multinational cohort registries, we investigated 1) the spectrum of PH in SSA; 2) the clinical profile and 6 months outcome of PH-LHD; 3) the role of electrocardiogram for diagnosing PH and 4) its prognostic role in heart failure (HF). PH was diagnosed by echocardiography in the context of clinical suspicion. Results: In high income countries, PH-LHD is almost invariably associated with increased mortality risk, but the effects on hospitalization are yet to be fully characterized. All groups of PH are found in SSA with LHD being the major cause. PH-LHD affects young people and is predominantly due to HF and rheumatic valvular heart disease. In these patients, left atrium size and tricuspid annular plan excursion are predictors of pulmonary pressures, and PH-LHD predicts short term hospitalization but not mortality. A normal electrocardiogram is very rare in patients with PH, but electrocardiogram criteria of right ventricular strain are rather rare and non-specific. Similarly, electrocardiogram abnormalities are frequent among Africans with HF, some have prognostic value for mortality risk. Conclusion: PH-LHD is the most common form of PH in SSA, with affected patients presenting with advanced disease, and it is associated with adverse outcomes. ECG abnormalities are prevalent in both PH and HF, but few of these abnormalities have prognostic value for mortality risk. Evaluating the efficacy and safety of low-cost and available drugs in reducing HF hospitalizations in PH-LHD is a key future priority. Improving early diagnosis of PH should also be encouraged. 2016-01-25T11:50:11Z 2016-01-25T11:50:11Z 2015 Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/16533 eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Medicine Pulmonary hypertension Dzudie Tamdja, Anastase Innocent Predicting pulmonary hypertension and outcomes in patients with left heart disease |
| thesis_degree_str | Doctoral |
| title | Predicting pulmonary hypertension and outcomes in patients with left heart disease |
| title_full | Predicting pulmonary hypertension and outcomes in patients with left heart disease |
| title_fullStr | Predicting pulmonary hypertension and outcomes in patients with left heart disease |
| title_full_unstemmed | Predicting pulmonary hypertension and outcomes in patients with left heart disease |
| title_short | Predicting pulmonary hypertension and outcomes in patients with left heart disease |
| title_sort | predicting pulmonary hypertension and outcomes in patients with left heart disease |
| topic | Medicine Pulmonary hypertension |
| url | http://hdl.handle.net/11427/16533 |
| work_keys_str_mv | AT dzudietamdjaanastaseinnocent predictingpulmonaryhypertensionandoutcomesinpatientswithleftheartdisease |