Disease characteristics and clinical outcome over two decades from the Swiss pulmonary hypertension registry.

Appenzeller, Paula; Lichtblau, Mona; Berlier, Charlotte; Aubert, John-David; Azzola, Andrea; Fellrath, Jean-Marc; Geiser, Thomas; Lador, Frederic; Pohle, Susanne; Opitz, Isabelle; Schwerzmann, Markus; Stricker, Hans; Tamm, Michael; Saxer, Stéphanie; Ulrich, Silvia (2022). Disease characteristics and clinical outcome over two decades from the Swiss pulmonary hypertension registry. Pulmonary circulation, 12(1), e12001. Sage 10.1002/pul2.12001

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Pulmonary hypertension (PH), especially pulmonary arterial and chronic thromboembolic pulmonary hypertension (PAH/CTEPH), are rare and progressive conditions. Despite recent advances in treatment and prognosis, PH is still associated with impaired quality of life and survival. Long-term PH-registry data provide information on the changing PH-epidemiology and may help to direct resources to patient's needs. This retrospective analysis of the Swiss Pulmonary Hypertension Registry includes patients newly diagnosed with PH (mainly PAH/CTEPH) registered from January 2001 to June 2019 at 13 Swiss hospitals. Patient characteristics (age, body mass index, gender, diagnosis), hemodynamics at baseline, treatment, days of follow-up, and events (death, transplantation, pulmonary endarterectomy, or loss to follow-up) at last visit were analyzed. Patients were stratified into four time periods according to their date of diagnosis. Survival was analyzed overall and separately for PAH/CTEPH and time periods. 1427 PH patients were included (thereof 560 PAH, 383 CTEPH). Over the years, age at baseline (mean ± SD) significantly increased from 59 ± 14 years in 2001-2005 to 66 ± 14 years in 2016-2019 (p < 0.001) while the gender distribution tended toward equality. Mean pulmonary artery pressure and pulmonary vascular resistance significantly decreased over time (from 46 ± 15 to 41 ± 11 mmHg, respectively, 9 ± 5 to 7 ± 4 WU, p < 0.001). Three-year survival substantially increased over consecutive periods from 69% to 91% (for PAH 63%-95%, for CTEPH 86%-93%) and was poorer in PAH than CTEPH independently of time period (p < 0.001). Most patients were treated with mono- or combination therapy and an increasing number of CTEPH underwent pulmonary endarterectomy (40% 2016-2019 vs. 15% 2001-2005). This long-term PH registry reveals that over two decades of observation, newly diagnosed patients are older, less predominantly female, have less impaired hemodynamics and a better survival.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Geiser, Thomas (A), Schwerzmann, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2045-8932

Publisher:

Sage

Language:

English

Submitter:

Pubmed Import

Date Deposited:

06 May 2022 09:38

Last Modified:

29 Mar 2023 23:38

Publisher DOI:

10.1002/pul2.12001

PubMed ID:

35506112

Uncontrolled Keywords:

chronic thromboembolic pulmonary hypertension pulmonary arterial hypertension survival

BORIS DOI:

10.48350/169791

URI:

https://boris.unibe.ch/id/eprint/169791

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