Pulmonary arterial hypertension – Experience of Centro Hospitalar de Vila Nova de Gaia
Hipertensão arterial pulmonar – Experiência do Centro Hospitalar de Vila Nova de Gaia
Ana Oliveira1, Daniela Ferreira1, António Caiado2, Susana Ferreira1, Paula Ferreira1, Lino Santos3, Manuel Gonçalves4, Teresa Shiang5, Bárbara Parente6, Rosas Vieira7, Vasco Gama Ribeiro8
1 Interna Complementar de Pneumologia / Pulmonolgy resident
2 Assistente Hospitalar de Pneumologia / Pulmonolgy consultant
3 Assistente Hospitalar de Cardiologia / Cardiology consultant
4 Assistente Hospitalar Graduado de Medicina Interna / Internal Medicine specialist consultant
5 Assistente Hospitalar Graduada de Pneumologia / Pulmonolgy specialist consultant
6 Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4430 Vila Nova de Gaia
7 Serviço de Medicina Interna, Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4430 Vila Nova de Gaia
8 Serviço de Cardiologia, Centro Hospitalar de Vila Nova de Gaia Rua Conceição Fernandes 4430 Vila Nova de Gaia
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class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pulmonary arterial hypertension (PAH) is a serious and progressive disease, potentially fatal in a few years. Until the 1990s the only effective treatment for this disease was pulmonary/cardiopulmonary transplant. Over the last few years several drugs have emerged that have modified the course of the disease.</p> <span class="elsevierStyleSectionTitle">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To characterise patients with PAH followed at Centro Hospitalar de V.N.Gaia between 2000 and 2006. To raise awareness of this entity.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis of all patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH) followed at our Hospital.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">In this period 11 patients were observed, 7 women and 4 men, with a mean age of 43 y. Five patients had idiopathic PAH, three had CTEPH, two had PAH associated with interauricular communication and one had PAH associated with CREST Syndrome.</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">At the time of diagnosis most patients were in NYHA//WHO Functional Class III/IV, mean systolic pulmonary artery pressure was 98±32mmHg and mean distance walked in the 6-minute walk test was 401m. Initial treatment: Three patients had inhaled iloprost, two subcutaneous treprostinil, three oral bosentan, one oral sildenafil and two patients underwent surgery. Mean follow-up time was 28.1 months. Five patients recovered, three are stable, one worsened and two died.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">PAH is a serious illness which requires a multidisciplinary approach with the need for complex and expensive therapies. Diagnosis in initial stages is essential for an effective treatment.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span class="elsevierStyleSectionTitle">Introdução</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A hipertensão arterial pulmonar (HAP) é uma doença grave e progressiva potencialmente fatal em poucos anos. Até à década de 90, o único tratamento eficaz para esta entidade era o transplante pulmonar/cardiopulmonar. Nos últimos anos assistiu-se ao aparecimento de novos fármacos que vieram alterar o curso da doença.</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Caracterização dos doentes com HAP observados no Centro Hospitalar de VN Gaia no período de 2000 a 2006. Alertar para esta entidade.</p> <span class="elsevierStyleSectionTitle">Material e métodos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Análise retrospectiva de todos os doentes com HAP ou doença tromboembólica crónica em tratamento no CHVN Gaia.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">No referido período foram observados 11 doentes, 7 mulheres e 4 homens, com média etária de 43 anos. Cinco doentes com HAP idiopática, três com doença tromboembólica crónica, dois com HAP associada a comunicação interauricular e um com HAP associada a S. CREST. Ao diagnóstico, a maioria encontrava- se em classe funcional NYHA/OMS III/IV, a pressão sistólica média da artéria pulmonar foi de 98±32mmHg e a distância média percorrida na 6-MWT foi de 401m. Terapêutica inicial: Três doentes iloprost por via inalatória; dois treprostinil subcutâneo; três bosentan <span class="elsevierStyleItalic">per os</span>; um sildenafil <span class="elsevierStyleItalic">per os</span> e dois doentes foram submetidos a cirurgia. O tempo médio de <span class="elsevierStyleItalic">follow-up</span> é de 28,1±20.3 meses. Cinco doentes melhoraram, três mantiveram-se estáveis, um agravou e dois faleceram.</p> <span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A HAP é uma doença grave que requer uma abordagem multidisciplinar com necessidade de terapêuticas complexas e dispendiosas. O diagnóstico em estádios precoces é essencial, de modo a permitir uma terapêutica atempada.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines On Diagnosis And Treatment Of Pulmonary Arterial Hypertension" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "for The Task Force On Diagnosis And Treatment Of Pulmonary Arterial Hypertension Of The European Society Of Cardiology" "etal" => true "autores" => array:1 [ 0 => "N. Galié" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur J Cardiol" "fecha" => "2004" "volumen" => "25" "paginaInicial" => "2243" "paginaFinal" => "2278" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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