Relationships between clinico-biochemical markers and echo parameter including right ventricle strain with severity of pulmonary arterial hypertension (group I) in Ibn-albitar cardiac center

Abstract

Background: A quickly developing condition, pulmonary arterial hypertension eventually results in right heart failure and death. Increasing research suggests that early intervention rather than postponing therapy produces better outcomes. Several factors, including functional classification, exercise ability, cardiac imaging results, and biomarker levels, have been proven to predict longevity both at the time of diagnosis and after therapy. Aim of study: To determined 6MWT, biological marker (CRP, S. URIC ACID, BNP) & RV strain as predictor of PAH of according to MRASP. Method: This a cross sectional study was conducted between the first of May, 2019 and the first of May, 2020 among patients with approved diagnosis of pulmonary artery hypertension and admitted to the Ibn AL- Baitar heart Center. This study excluded every patient with Poor image quality, Atrial fibrillation or Flutter, Pregnancy, Patients with other causes of PAH, Unable to perform 6MWT and Renal failure. BNP, CRP and uric acid were measured to all patients and echocardiography was done, also Six-minute walk distance measured than The modified risk assessment score of PAH was determined and according to it patients categorized into low-risk, intermediate-risk, and high-risk. Result: a total of 31 patients were enrolled in this study. The percentage of patients with impaired GLS was 26(86.6%) patients, BNP was raised in 73.3% (22) of patients and there were 14(45.2%) patients with low score and 17 (58.8%) patients with intermediate- high score. The mean CRP was significantly lower in low MRASP score than intermediate – high MRASP score (4.1 vs 7.4) with p value =0.001, The echocardiography parameters that shown significant difference between patients with low and intermediate - high MRASP were inferior vena cava diameter, RV pulse velocity and GLS. Conclusion: The approach to risk assessment is useful tool in assessing patient with PAH.