Pulmonary arterial hypertension in France: results from a national registry

M Humbert, O Sitbon, A Chaouat… - American journal of …, 2006 - atsjournals.org
M Humbert, O Sitbon, A Chaouat, M Bertocchi, G Habib, V Gressin, A Yaici, E Weitzenblum…
American journal of respiratory and critical care medicine, 2006atsjournals.org
Rationale: Pulmonary arterial hypertension (PAH) is an orphan disease for which the trend
is for management in designated centers with multidisciplinary teams working in a shared-
care approach. Objective: To describe clinical and hemodynamic parameters and to provide
estimates for the prevalence of patients diagnosed for PAH according to a standardized
definition. Methods: The registry was initiated in 17 university hospitals following at least five
newly diagnosed patients per year. All consecutive adult (⩾ 18 yr) patients seen between …
Rationale: Pulmonary arterial hypertension (PAH) is an orphan disease for which the trend is for management in designated centers with multidisciplinary teams working in a shared-care approach.
Objective: To describe clinical and hemodynamic parameters and to provide estimates for the prevalence of patients diagnosed for PAH according to a standardized definition.
Methods: The registry was initiated in 17 university hospitals following at least five newly diagnosed patients per year. All consecutive adult (⩾ 18 yr) patients seen between October 2002 and October 2003 were to be included.
Main Results: A total of 674 patients (mean ± SD age, 50 ± 15 yr; range, 18–85 yr) were entered in the registry. Idiopathic, familial, anorexigen, connective tissue diseases, congenital heart diseases, portal hypertension, and HIV-associated PAH accounted for 39.2, 3.9, 9.5, 15.3, 11.3, 10.4, and 6.2% of the population, respectively. At diagnosis, 75% of patients were in New York Heart Association functional class III or IV. Six-minute walk test was 329 ± 109 m. Mean pulmonary artery pressure, cardiac index, and pulmonary vascular resistance index were 55 ± 15 mm Hg, 2.5 ± 0.8 L/min/m2, and 20.5 ± 10.2 mm Hg/L/min/m2, respectively. The low estimates of prevalence and incidence of PAH in France were 15.0 cases/million of adult inhabitants and 2.4 cases/million of adult inhabitants/yr. One-year survival was 88% in the incident cohort.
Conclusions: This contemporary registry highlights current practice and shows that PAH is detected late in the course of the disease, with a majority of patients displaying severe functional and hemodynamic compromise.
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