Multiprofessional and Intrahospital Experience for Diagnosis and Treatment of Pulmonary Arterial Hypertension

Michele Correale; Deodata Montrone; Donato Lacedonia; Riccardo Ieva; Romano Bucci; Addolorata Corrado; Francesco Paolo Cantatore; Carmen Adriana Greco; Morena Concilio; Gaetano Serviddio; Maria Pia Foschino Barbaro; Matteo Di Biase; Natale Daniele Brunetti

doi:10.4081/monaldi.2012.113

https://doi.org/10.4081/monaldi.2012.113

Authors

Michele Correale | opsfco@tin.it Department of Cardiology, University of Foggia, Italy.
Deodata Montrone Department of Cardiology, University of Foggia, Italy.
Donato Lacedonia Institute of Respiratory Diseases, University of Foggia, Italy.
Riccardo Ieva Department of Cardiology, University of Foggia, Italy.
Romano Bucci Rheumatology Clinic, â€œOspedali Riunitiâ€, Foggia, Italy.
Addolorata Corrado Rheumatology Clinic, Department of Medical and Occupational Sciences, University of Foggia, Italy.
Francesco Paolo Cantatore Rheumatology Clinic, Department of Medical and Occupational Sciences, University of Foggia, Italy.
Carmen Adriana Greco Department of Cardiology, University of Foggia, Italy.
Morena Concilio Department of Cardiology, University of Foggia, Italy.
Gaetano Serviddio Institute of Internal Medicine, Department of Medical and Occupational Sciences, University of Foggia, Italy.
Maria Pia Foschino Barbaro Institute of Respiratory Diseases, University of Foggia, Italy.
Matteo Di Biase Department of Cardiology, University of Foggia, Italy.
Natale Daniele Brunetti Department of Cardiology, University of Foggia, Italy.

Abstract

Background. Referral centres for pulmonary hypertension will provide care by a multiprofessional team, which should as a minimum comprise: consultant physicians with a special interest in PH, clinical nurse specialist, radiologist, cardiologist with expertise in echocardiography. Aims. this study sought to determine whether the experience of the establishment of a clinic for pulmonary arterial hypertension, initially created only for the treatment and diagnosis of heart failure, may be considered positive. Methods. From 1 July 2008 to January 1, 2012 we evaluated 80 patients in our ambulatory dedicated to the diagnosis and treatment of PAH. All patients were performed to clinical evaluation, ECG, and echocardiography with estimation of the sPAP. Then we evaluated the functional capacity through cardiopulmonary exercise testing or six minute walking test (6MWT). RHC was required to confirm the diagnosis of pulmonary arterial hypertension. Results. 80 patients (mean age: 50.9 Â± 18.68 years, 31 males) were evaluated in our center; the largest groups subjected to screening were thalassemia (21 subjects), rheumatologic patients (18 patients), respirators, suspected of â€œoutof Proportionâ€ (12 patients) and 4 patients with OSAS. 8 adult congenital heart patients. A diagnosis of PAH after right heart catheterization was possible in 25 cases. In particular, among patients with pulmonary arterial hypertension, 8 had a rheumatic etiology (systemic sclerosis), 2 postthromboembolic disease, 5 patients had congenital heart disease, 1 patient with HIV infection, 1 patient with thalassemia major, 1 chronic lymphocytic leukemia and 1 with myelodysplasia. Conclusions. The initial experience of our center and network within our hospital may be considered positive, because it permitted to patients easy access to hospital services, to undertake a comprehensive prognostic stratification and to recognize the early signs of worsening in subsequent tests.