Jo YS, et al. – The aim of this retrospective cohort study was to identify the risk factors for pulmonary arterial hypertension (PAH) and their impact on acute exacerbation and mortality in patients with tuberculosis–destroyed lung (TDL), as well as the clinical differences in patients with chronic obstructive pulmonary disease (COPD) and PAH. The findings demonstrated that PAH in patients with TDL was related to the severity of lung destruction, however, the risk of exacerbation and mortality did not significantly differ between patients with PAH and without PAH.

Methods

• This study was directed from 2010 through 2015 in a municipal referral hospital in South Korea.
• PAH was characterized when echocardiographic pulmonary arterial pressure (PAP) was >40 mmHg.
• The clinical features and course of TDL patients with or without PAH were assessed and differences between patients with COPD and PAH were analyzed.

Results

• Among the one hundred ninety-five patients with TDL, echocardiographic data were available in fifty-three patients, and their mean PAP was 50.72±23.99 mmHg.
• It was observed in the findings that the PAH group (n=37) had a smaller lung volume (forced vital capacity % predicted, 51.55% vs 72.37%, P<0.001) and more extensively destroyed lungs (3.27 lobes vs 2 lobes, P<0.001) than those in the non-PAH group (n=16).
• The data presented in this work showed a higher PAP was significantly associated with a higher frequency of acute exacerbation (r=0.32, P=0.02).
• Multivariate analyses did not uncover any significant risk factors contributing to PAH in patients with TDL.
• TDL patients with PAH have smaller lung volume but a less severe airflow limitation compared to COPD patients with PAH.
• Tricuspid regurgitation and a D-shaped left ventricle during diastole were more frequently seen in TDL patients.
• The authors found that the risk of exacerbation was not different between patients with PAH in COPD and TDL.