Development of pulmonary artery hypertension (PAH) worsens prognosis of systemic sclerosis (SSc) and can be either isolated precapillary PAH or secondary to interstitial lung disease (ILD). Early diagnosis is of crucial importance. There is scarcity of data on PAH in patients with SSc in Bangladesh. The objective if the study is to determine the Prevalence and clinical correlates of pulmonary hypertension in systemic sclerosis. Clinical and functional characteristics of 100 patients of systemic sclerosis were studied and they were evaluated by echocardiography to detect pulmonary artery hypertension. Our objective was to study the prevalence and the clinical correlation of PAH in SSc. PAH was found in 29% patients on echocardiography. Prevalence tend to increase with age of onset and duration of disease. However, it did not differ significantly between patients with limited cutaneous SSc (lcSSc) and patients with diffuse cutaneous SSc (dcSSc). On binary logistic regression analysis, none of the studied variables had any independent influence on development of PAH. PAH in SSc occurs in a remarkable proportion (29%) of patients without any ominous signs in early stages. Non-invasive screening of patients with SSc for PAH will help in early diagnosis and appropriate timely therapeutic intervention before significant end-organ damage occurs.
The primary aim of the current investigation was to evaluate the role of NT-proBNP in the diagnosis of diastolic heart failure and its correlation with echocardiography. Hospital based observational and analytical study undertaken on a total of 65 patients of diastolic heart failure fulfilling clinical inclusion criteria. The enrolled patients had a mean age of 54.5 years with a female preponderance (33 females vs. 32 males). Patients underwent clinical evaluation and echocardiography examination. NT-proBNP estimation was done using autoanalyzer working on principle of electrochemiluminisense. Patients were divided into various grades of diastolic dysfunction on the basis of echocardiography. Statistical analysis was done to find the significance of levels of NT-proBNP and its correlation with the grading of diastolic heart failure. There was a statistically significant higher level of serum NT-proBNP in patients with diastolic heart failure and the increasing levels were directly proportional to severity of diastolic dysfunction. The mean level of NTproBNP increased from 361.08 pg/ml to 3570 pg/ml in increasing severity of diastolic dysfunction. Results suggested positive correlation of rising NT-proBNP levels with increasing severity of diastolic dysfunction.
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