Resumo

AMARU, Ricardo et al. PULMONARY ARTERIAL HYPERTENSION IN PATIENTS WITH PATHOLOGICAL ERYTHROCYTOSIS. Rev. Méd. La Paz [online]. 2019, vol.25, n.2, pp.27-35. ISSN 1726-8958.

Introduction. Pathological erythrocytoses (PE) are characterized by increasing erythrocyte mass, hemoglobin (Hb) and hematocrit (Ht), besides are frequent in highlanders. Pulmonary Arterial Hypertension (PAH) is one of the complications in PE and its detection depends on systolic Pulmonary Arterial Pressure (sPAP). It is considered PAH when sPAP is greater than 35 mmHg. Objective. To determine incidence and severity of PAH in patients with PE, likewise the utility of Atorvastatin (ATV) and Acetyl Salicylic Acid (ASA) for its treatment. Material and methods. Prospective study in 44 men, 38 PE patients and 6 Normal Controls (CN). Laboratory studies and TTE were performed at diagnosis and 6 months later. Phlebotomies of 450 ml were performed in patients until getting Hb <18 g/dl, then they started treatment with ATV 20 mg and ASA 100 mg. Systemic blood pressure, heart rate, respiratory rate, CBC, BMI and serum Epo were monitored. Results. CN and patients with PE differed in Hb (16.1 vs21.1 g/dl), serum Epo (16.6 vs. 39.9 mUI/ml), sPAP (28.1 vs. 39.4 mmHg) and heart muscle damage (0.0 vs. 81%). Considering a 6-month follow-up in treated patients, decrease of Hb from 21.2 to 18 g/dl, serum Epo from 43 to 37 mUI/ml and sPAP from 37.7 to 33 mmHg were evidenced, without modifications in anatomical heart lesions. Conclusion. Incidence of PAH in PE patients stands for 71% with a correlation among PAH, serum Epo concentration and erythrocytosis. ATV and ASA constitute a treatment option for PAH in PE patients at high altitude.

Palavras-chave : Pathological erythrocytosis; Pulmonary Arterial Hypertension; Systolic Pulmonary Arterial Pressure; Atorvastatin; Acetyl Salicylic Acid.

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