Browsing by Author "Messo, Aino"

Pulmonary hypertension is characterized by an increase in pulmonary vascular resistance, mean pulmonary arterial pressure, and the subsequent progressive right ventricular afterload, leading to right heart failure and premature death. Recent advancements in the management of pulmonary hypertension, particularly in pulmonary arterial hypertension (PAH), and chronic thromboembolic pulmonary hypertension (CTEPH), have substantially improved patient prognoses. Presently, there is little research done on the Finnish PH population. Data extracted from the HUSPAH registry was analyzed to assess the characteristics, treatment, and outcomes of Finnish patients newly diagnosed with PAH or CTEPH between 2008 and 2022. The treatment effect of different interventions was evaluated, and the survival of different subgroups was studied. A total of 186 patients were included in this study (93 PAH, and 93 CTEPH). The mean age of PAH patients was 54 years, 74% were female, and 34% had idiopathic PAH. Advanced age (p<0.01), poor exercise capacity (p<0.01), ischemic heart disease (p<0.01), and poor diffusion capacity (p<0.01) predicted poor treatment response. The prevalence of combination therapies was low at baseline and in follow-up. The 1-, 3-, and 5-year survival of our PAH cohort was 97.8%, 84.3%, and 68.1%, respectively. The mean age of CTEPH patients was 57 and 52% were female. Advanced age (p<0.01), poor exercise capacity (p<0.01), and exclusively distal lesions in pulmonary vasculature (p=0.02) were the main determinants against operability with PEA. Operated patients achieved superior clinical and hemodynamic results, although survival between operated and nonoperated patients wasn’t statistically significant. The 1-, 3-, and 5-year survival of our CTEPH cohort was 100.0%, 93.9%, and 87.4%, respectively. The clinical state of pulmonary hypertension among Finnish patients is superior to European patients. Treatment strategies follow international trends, albeit combination therapies among PAH patients are underutilized. Our patients reach similar treatment outcomes, and superior survival compared to other European registries.