HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort
Abstract In sub-Saharan Africa, little is known about pulmonary hypertension in left heart disease (PH-LHD). We used multivariate logistic and cox-hazard proportional regression models to examine factors associated with increased right ventricular systolic pressure (RVSP) and the effect of real-worl...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-36375-y |
| _version_ | 1797801503477465088 |
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| author | Patrick D. M. C. Katoto Sandra L. Mukasa Mahmoud U. Sani Kamilu M. Karaye Irina Mbanze Albertino Damasceno Ana O. Mocumbi Anastase Dzudie Karen Sliwa Friedrich Thienemann |
| author_facet | Patrick D. M. C. Katoto Sandra L. Mukasa Mahmoud U. Sani Kamilu M. Karaye Irina Mbanze Albertino Damasceno Ana O. Mocumbi Anastase Dzudie Karen Sliwa Friedrich Thienemann |
| author_sort | Patrick D. M. C. Katoto |
| collection | DOAJ |
| description | Abstract In sub-Saharan Africa, little is known about pulmonary hypertension in left heart disease (PH-LHD). We used multivariate logistic and cox-hazard proportional regression models to examine factors associated with increased right ventricular systolic pressure (RVSP) and the effect of real-world HIV status scenarios on 6-month survival rate in the Pan African Pulmonary Hypertension Cohort (PAPUCO) study, a prospective cohort from four African countries. Exposure to biomass fuel smoke (aOR, 95%CI 3.07, 1.02–9.28), moderate to severe NYHA/FC III/IV (aOR, 95%CI 4.18, 1.01–17.38), and unknown HIV status (aOR, 95%CI 2.73, 0.96–7.73) predicted moderate to severe RVSP at the time of presentation. Six months later, HIV infection, moderate-to-severe NYHA/FC, and alcohol consumption were associated with decreased survival probabilities. Upon adjusting for HIV infection, it was observed that an incremental rise in RVSP (1 mmHg) and inter-ventricular septal thickness (1 mm) resulted in an 8% (aHR, 95%CI 1.08, 1.02–1.13) and 20% (aHR, 95%CI 1.2, 1.00–1.43) increase in the probability of mortality due to PH-LHD. In contrast, the risk of death from PH-LHD was reduced by 23% for each additional unit of BMI. (aHR, 95%CI 0.77, 0.59–1.00). In conclusion, the present study offers insights into the determinants that are notably linked to unfavorable survival outcomes in patients with pulmonary hypertension due to left heart disease. Certain factors identified in this study are readily evaluable and amenable to modification, even in settings with limited resources. |
| first_indexed | 2024-03-13T04:51:28Z |
| format | Article |
| id | doaj.art-6112c11df6f24a399bbc61114525ffff |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-13T04:51:28Z |
| publishDate | 2023-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-6112c11df6f24a399bbc61114525ffff2023-06-18T11:11:52ZengNature PortfolioScientific Reports2045-23222023-06-0113111410.1038/s41598-023-36375-yHIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension CohortPatrick D. M. C. Katoto0Sandra L. Mukasa1Mahmoud U. Sani2Kamilu M. Karaye3Irina Mbanze4Albertino Damasceno5Ana O. Mocumbi6Anastase Dzudie7Karen Sliwa8Friedrich Thienemann9Cape Heart Institute and Department of Medicine, Faculty of Health Science, University of Cape TownCape Heart Institute and Department of Medicine, Faculty of Health Science, University of Cape TownDepartment of Medicine, Bayero University Kano & Aminu Kano Teaching HospitalDepartment of Medicine, Bayero University Kano & Aminu Kano Teaching HospitalFaculty of Medicine, Eduardo Mondlane UniversityFaculty of Medicine, Eduardo Mondlane UniversityFaculty of Medicine, Eduardo Mondlane UniversityDepartment of Internal Medicine, Douala General HospitalCape Heart Institute and Department of Medicine, Faculty of Health Science, University of Cape TownCape Heart Institute and Department of Medicine, Faculty of Health Science, University of Cape TownAbstract In sub-Saharan Africa, little is known about pulmonary hypertension in left heart disease (PH-LHD). We used multivariate logistic and cox-hazard proportional regression models to examine factors associated with increased right ventricular systolic pressure (RVSP) and the effect of real-world HIV status scenarios on 6-month survival rate in the Pan African Pulmonary Hypertension Cohort (PAPUCO) study, a prospective cohort from four African countries. Exposure to biomass fuel smoke (aOR, 95%CI 3.07, 1.02–9.28), moderate to severe NYHA/FC III/IV (aOR, 95%CI 4.18, 1.01–17.38), and unknown HIV status (aOR, 95%CI 2.73, 0.96–7.73) predicted moderate to severe RVSP at the time of presentation. Six months later, HIV infection, moderate-to-severe NYHA/FC, and alcohol consumption were associated with decreased survival probabilities. Upon adjusting for HIV infection, it was observed that an incremental rise in RVSP (1 mmHg) and inter-ventricular septal thickness (1 mm) resulted in an 8% (aHR, 95%CI 1.08, 1.02–1.13) and 20% (aHR, 95%CI 1.2, 1.00–1.43) increase in the probability of mortality due to PH-LHD. In contrast, the risk of death from PH-LHD was reduced by 23% for each additional unit of BMI. (aHR, 95%CI 0.77, 0.59–1.00). In conclusion, the present study offers insights into the determinants that are notably linked to unfavorable survival outcomes in patients with pulmonary hypertension due to left heart disease. Certain factors identified in this study are readily evaluable and amenable to modification, even in settings with limited resources.https://doi.org/10.1038/s41598-023-36375-y |
| spellingShingle | Patrick D. M. C. Katoto Sandra L. Mukasa Mahmoud U. Sani Kamilu M. Karaye Irina Mbanze Albertino Damasceno Ana O. Mocumbi Anastase Dzudie Karen Sliwa Friedrich Thienemann HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort Scientific Reports |
| title | HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort |
| title_full | HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort |
| title_fullStr | HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort |
| title_full_unstemmed | HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort |
| title_short | HIV status and survival of patients with pulmonary hypertension due to left heart disease: the Pan African Pulmonary Hypertension Cohort |
| title_sort | hiv status and survival of patients with pulmonary hypertension due to left heart disease the pan african pulmonary hypertension cohort |
| url | https://doi.org/10.1038/s41598-023-36375-y |
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