RESUMEN
BACKGROUND: Pulmonary hypertension (PH) is a global health issue that has profound medical and research implications. METHODS: This retrospective study examined changes in renal and liver function, as well as lipid metabolism, over a 12-month period in 49 adult patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). All cases were admitted, managed, and followed up with in the PH Center, County Emergency Clinical Hospital of Targu Mures, Romania. RESULTS: Kidney dysfunction was observed in 12.24% of cases at baseline, decreasing to 8.16% at 12 months, and CTEPH patients were more affected. In particular, CTEPH patients exhibited an improvement in renal function, confirmed by an increase in their glomerular filtration rates. Hepatic impairment was present in 57.14% of subjects at baseline, declining to 42.86% at 12 months, with significant improvements noted in the PAH group. Lipid metabolic dysregulations were experienced by 22.45% of all patients at baseline, decreasing to 16.33% at 6 months, with a slow elevation to 24.49% at 12 months, but with no statistically significant differences. Pharmacological regimens were adjusted in accordance with the PH groups, a patient's functional and clinical response, and laboratory tests. CONCLUSIONS: Our results demonstrate the multi-organ damage in PH and the importance of individualized treatment approaches.
RESUMEN
Background and Objectives: Heart transplant is currently the final step in treating patients with heart failure. The success of this procedure is strongly connected to potential complications such as postoperative heart failure, infections, graft rejection, graft vasculopathy, and kidney failure. Thus, identifying potential prognostic factors for patients' outcome is of utmost importance. We investigated the prognostic role of the postoperative ratio between the tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (sPAP) in patients who underwent heart transplantation in our center. Materials and Methods: The study included 46 adult patients from the Emergency Institute for Cardiovascular Diseases and Transplant of Târgu MureÈ, who underwent heart transplant between January 2011 and April 2023. By the use of receiver operating characteristic (ROC) analysis, we determined an optimal cut-off value for TAPSE/sPAP with regard to survival at 6 months. Differences in central tendencies of baseline characteristics in those who had a value lower than the cut-off value of TAPSE/sPAP and those who presented a value above it were investigated using the corresponding parametric or nonparametric tests. Results: A value for TAPSE/sPAP above 0.47 mm/mmHg was associated with 6-month survival (OR: 59.5, CI: 5.7-616.0). No significant differences in central tendencies for baseline characteristics were found between the patients who had a TAPSE/sPAP ratio below the cut-off and those who had a ratio above it. Conclusions: The TAPSE/sPAP ratio might prove to be valuable in the early identification of at-risk heart transplant patients. Further prospective studies with larger cohorts are required for validation.