Clinicoradiological and cardiac profile of pulmonary artery hypertension in treated patients of pulmonary tuberculosis in a tertiary center

• Main Authors: Achal B Parekh, Anand K Patel, Mayur H Adalja
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Indian Journal of Respiratory Care
• Subjects: echocardiography; electrocardiography; pulmonary artery hypertension; pulmonary artery systolic pressure; pulmonary tuberculosis; tricuspid regurgitation
• Online Access: http://www.ijrconline.org/article.asp?issn=2277-9019;year=2020;volume=9;issue=1;spage=62;epage=67;aulast=Parekh

Introduction: Tuberculosis (TB) is a global health burden. Pulmonary TB (PTB) can cause important thoracic sequelae involving the lungs, airways, vessels, mediastinum, pleura, and chest wall. Pulmonary hypertension (PAH) is a serious respiratory disability occurring from structural lung damage and chronic hypoxia. Aims and Objectives: The aim of this study is to evaluate the clinical, radiological, and echocardiographic profile of PAH in patients treated for PTB and how they correlate with each other. Patients and Methods: This was a cross-sectional study. A total of 100 patients with PAH with a history of PTB were analyzed. Chest X-ray, electrocardiogram (ECG), and two-dimensional-echocardiography were obtained in all of them. Detailed clinical and radiological profile of those having PAH was noted. The usefulness of echocardiography for diagnosing cor pulmonale was studied. Results: We investigated 75 males and 25 females. Cough was the most common presenting symptom. The mean time since the treatment of PTB was 7.5 years. The most common radiological abnormality, fibrocavitation was found in 25% of the patients, whereas P-pulmonale was the most common finding on ECG. Majority of the patients had moderate PAH with a pulmonary arterial systolic pressure 50–65 mmHg. There was a significant relationship between PAH and tricuspid regurgitation (TR) (P < 0.05). No statistical association was seen between the right ventricle internal diameter at end-diastole and TR and PAH. No relationship was seen between years of treatment completed for PTB and PAH. Conclusion: Treated patients of PTB presented with different grades of PAH on an average of 7 years after therapy. Hence, early diagnosis, treatment, and long-term follow-up of PTB are of foremost importance to prevent posttubercular complications and respiratory disability.