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<p>Schistosomiasis-associated PAH (Sch-PAH) falls under group I pulmonary hypertension and it affects 230 million people, mainly in sub-Saharan Africa. This significant burden has prompted studies on the clinical characteristics and outcomes of Sch-PAH to improve awareness and management, particularly in developing regions. This study investigates the characteristics of Sch-PAH, including demographics, clinical and hemodynamic features, and survival outcomes compared to idiopathic Pulmonary arterial hypertension (IPAH), while evaluating the prognosis and current clinical practices. A cohort of 83 patients, including 41 with Sch-PAH and 42 with IPAH, were studied retrospectively over five years (2019–2024) from 3 pulmonary hypertension centres in Egypt. Data collection focused on demographic details, comorbidities, echocardiographic findings, and survival rates. Sch-PAH patients were significantly older (50.4 ± 12&#xa0;years) and predominantly male (<i>P</i> &lt; 0.001) compared to IPAH patients (34.5 ± 9.7&#xa0;years). Higher comorbidity rates, chiefly chest and hepatic disorders, were observed in Sch-PAH. The Sch-PAH group exhibited more WHO functional class IV cases and greater left atrium (LA) and pulmonary artery (PA) dilation (<i>P</i> = 0.007, <i>P</i> = 0.006, <i>P</i> = 0.01, respectively). Lower ejection fraction (EF%) and absence of PA dilation and portal hypertension were linked to improved survival, with EF% emerging as an independent survival predictor (OR = 0.72 and 0.55; <i>P</i> = 0.002 and &lt; 0.001). The EF% cutoff below 66% showed high predictive accuracy for survival (AUC = 0.85, <i>P</i> = 0.008). Sch-PAH affects primarily older males with significant comorbidities. Its prevalence poses a public health challenge, making the identification of mortality predictors crucial for early patient risk assessment and improved prognosis management.</p>

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Clinical and hemodynamic evaluation of schistosomiasis-associated pulmonary arterial hypertension from Egyptian pulmonary hypertension centers: epidemiology, risk factors, and survival determinants

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月21日

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  • Youssef M. Amin Soliman,
  • Mohamed El-Kassas,
  • Ahmed Abd ElAziz,
  • Mohamed Shaaban Mousa,
  • Mohamed Kamal Hasswa,
  • Sally Magdy,
  • Reem Elkorashy

摘要

Schistosomiasis-associated PAH (Sch-PAH) falls under group I pulmonary hypertension and it affects 230 million people, mainly in sub-Saharan Africa. This significant burden has prompted studies on the clinical characteristics and outcomes of Sch-PAH to improve awareness and management, particularly in developing regions. This study investigates the characteristics of Sch-PAH, including demographics, clinical and hemodynamic features, and survival outcomes compared to idiopathic Pulmonary arterial hypertension (IPAH), while evaluating the prognosis and current clinical practices. A cohort of 83 patients, including 41 with Sch-PAH and 42 with IPAH, were studied retrospectively over five years (2019–2024) from 3 pulmonary hypertension centres in Egypt. Data collection focused on demographic details, comorbidities, echocardiographic findings, and survival rates. Sch-PAH patients were significantly older (50.4 ± 12 years) and predominantly male (P < 0.001) compared to IPAH patients (34.5 ± 9.7 years). Higher comorbidity rates, chiefly chest and hepatic disorders, were observed in Sch-PAH. The Sch-PAH group exhibited more WHO functional class IV cases and greater left atrium (LA) and pulmonary artery (PA) dilation (P = 0.007, P = 0.006, P = 0.01, respectively). Lower ejection fraction (EF%) and absence of PA dilation and portal hypertension were linked to improved survival, with EF% emerging as an independent survival predictor (OR = 0.72 and 0.55; P = 0.002 and < 0.001). The EF% cutoff below 66% showed high predictive accuracy for survival (AUC = 0.85, P = 0.008). Sch-PAH affects primarily older males with significant comorbidities. Its prevalence poses a public health challenge, making the identification of mortality predictors crucial for early patient risk assessment and improved prognosis management.