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The prevalence of pulmonary hypertension after successful tuberculosis treatment in a community sample of adult patients

The prevalence of pulmonary hypertension after successful tuberculosis treatment in a community sample of adult patients

Louw, Eh ORCID: 0000-0003-4385-2249, Baines, N, Maarman, G, Osman, Muhammad ORCID: 0000-0003-3818-9729, Sigwadhi, Ln, Irusen, Em, Koegelenberg, Cfn, Doubell, Af, Nathan, Sd, Channick, R and Allwood, Bw (2023) The prevalence of pulmonary hypertension after successful tuberculosis treatment in a community sample of adult patients. Pulmonary Circulation, 13 (1):e12184. pp. 1-13. ISSN 2045-8940 (Online) (doi:https://doi.org/10.1002/pul2.12184)

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Abstract

There are an estimated 155 million survivors of tuberculosis (TB). Clinical experience suggests that post-pulmonary tuberculosis lung disease (PTLD) is an important cause of group 3 pulmonary hypertension (PH). However, TB is not listed as a cause of PH in most guidelines. A cross-sectional, community-based study was conducted in non-health care seeking adults who had successfully completed TB treatment. Subjects underwent questionnaires, spirometry, a six-minute walk distance test (6MWD) and transthoracic echocardiography (TTE). Screen probable PH was defined on TTE as an estimated pulmonary artery peak systolic pressure (PASP) of ≥40mmHg. One hundred adults (71 males) were enrolled, with a mean age of 42 years (SD 13.8 years) and a median of one TB episode (IQR: 1 -2). Co-morbidities included hypertension (21%), diabetes (16%), HIV (10%) and asthma/COPD (5%). Only 25% had no residual symptoms after TB. Probable PH was found in 9%, while 7% had borderline raised PASP values (PASP 35-40mmHg). An association was found between PH and the number of previous TB episodes, with each additional episode of TB increasing the odds of PH-post-TB 2.13-fold (CI 1.17-3.88; P=0.013). All of those found to have PH were smokers or ex-smokers yielding an unadjusted odds ratio for PH-post-TB of 3.67 (95%CI 0.77-17.46). There was no statistical difference in spirometry or 6MWD, between those with and without PH. Neither symptoms nor co-morbidities demonstrated significant association with PH. PH after TB was a common finding in this community-based population. Further research is needed to confirm and determine the significance of these findings.

Item Type: Article
Additional Information: Original article This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/pul2.12184
Uncontrolled Keywords: post-tuberculosis; pulmonary hypertension
Subjects: Q Science > QR Microbiology > QR355 Virology
R Medicine > R Medicine (General)
R Medicine > RB Pathology
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families
Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified: 07 Jul 2023 11:27
URI: http://gala.gre.ac.uk/id/eprint/38408

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