1. Prevalence of pulmonary hypertension in patients with hepatosplenic Mansonic schistosomiasis--prospective study.
- Author
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de Cleva R, Herman P, Pugliese V, Zilberstein B, Saad WA, Rodrigues JJ, and Laudanna AA
- Subjects
- Adolescent, Adult, Brazil, Catheterization, Swan-Ganz, Cross-Sectional Studies, Esophageal and Gastric Varices diagnosis, Esophageal and Gastric Varices epidemiology, Esophageal and Gastric Varices physiopathology, Female, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage epidemiology, Gastrointestinal Hemorrhage physiopathology, Hemodynamics physiology, Humans, Hypertension, Portal diagnosis, Hypertension, Portal epidemiology, Hypertension, Portal physiopathology, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary physiopathology, Liver Diseases, Parasitic diagnosis, Liver Diseases, Parasitic physiopathology, Male, Middle Aged, Monitoring, Physiologic, Prospective Studies, Pulmonary Artery physiology, Pulmonary Wedge Pressure physiology, Schistosomiasis mansoni diagnosis, Schistosomiasis mansoni physiopathology, Splenic Diseases diagnosis, Splenic Diseases physiopathology, Hypertension, Pulmonary epidemiology, Liver Diseases, Parasitic epidemiology, Schistosomiasis mansoni epidemiology, Splenic Diseases epidemiology
- Abstract
Background/aims: Thirty-four patients with portal hypertension and previous history of esophageal varices hemorrhage due to hepatosplenic Mansonic schistosomiasis were prospectively studied., Methodology: All patients underwent invasive hemodynamic monitoring with introduction of a pulmonary artery catheter. Hemodynamic evaluation was characterized by an increased cardiac index (4.90 +/- 1.27 L/min/m2) associated to a decrease in systemic vascular resistance index (1461 +/- 443.04 dynes.sec/cm5.m2)., Results: Mean pulmonary artery pressure (17.97 +/- 6.97 mmHg) and right atrial pressure (7.65 +/- 3.67 mmHg) were increased while pulmonary vascular resistance index was decreased (147.95 +/- 126.21 dynes.sec/cm5.m2). Twenty-four patients (70.5%) presented pulmonary hypertension (mean pulmonary artery pressure > 15 mmHg); in fifteen (44.1%) pulmonary pressure was between 15 and 20 mmHg, in three between 20 and 25 mmHg and, in four patients, pulmonary pressure was higher than 25 mmHg., Conclusions: In conclusion, pulmonary hypertension is a frequent complication in patients with portal hypertension due to hepatosplenic Mansonic schistosomiasis and, in 20.6% of the cases, it can be considered as moderate or severe. Our results suggest that shunt surgeries, which can aggravate pulmonary hypertension, should be employed very cautiously in the treatment of schistosomal portal hypertension.
- Published
- 2003