In recent years, the treatment of pulmonary arterial hypertension (PAH) has gradually increased, including new drugs and surgical methods, the mortality rate of PAH patients has significantly decreased, and the average survival rate has significantly improved. However, there was no obvious improvement in sexual health, mental health, and quality of life (QoL) in patients with PAH. Although an important dimension of QoL, little is known about sexual health and sexual health‐related QoL of patients with PAH in China. In this study, the female sexual function index (FSFI) scale, the Symptom Checklist‐90 (SCL‐90), and emPHasis‐10 were used to evaluate PAH associated with congenital heart disease (CHD‐PAH) patients’ sexual function, mental health, and QoL. The score of sexual function in female CHD‐PAH patients ranged from 4.40 to 34.80 points, and the average score was 26.80 (19.00–27.80) points. The detection rate of sexual dysfunction was 48.30%. The FSFI score of all dimensions of the sexual dysfunction group was significantly lower than that of the nonsexual dysfunction group. In addition, the scores of SCL‐90 and emPHasis‐10 were significantly higher than that of the nonsexual dysfunction group ( p < 0.01). The sexual function was negatively correlated with mental health ( r = −0.58, p < 0.01) and QoL ( r = −0.62, p < 0.01) in female CHD‐PAH patients. The sexual function of female patients with CHD‐PAH is not optimistic. Sexual health may impact mental health and overall QoL in female PAH patients. Reasonable intervention measures should be taken to improve their sexual health, so as to improve their overall QoL.
Objectives: The aim of this study was to measure the P-wave dispersion(PWD) in the ECG of patients with pulmonary arterial hypertension(PAH). Methods: A total of 103 PAH patients were collected, including 55 patients related with CHD and 44 patients with IPAH. In addition, 30 CHD patients without PAH (nPAH-CHD group) and 30 healthy controls (HCG group) were collected as control. Patients in the PAH group were categorized into the low-risk group (30 cases), moderate-risk group (53 cases) and high-risk group (20 cases), followed by comparison of PWD difference between groups. The ROC curve was used to evaluate the diagnostic efficacy of PWD on PAH-CHD and IPAH. Results: The levels of PWD and Pmax in PAH-CHD and IPAH group were significantly higher than those in nPAH-CHD and HCG group (P<0.05). PWD level was positively correlated with RVD, RAS, mPAP, PVR (r=0.407, 0.470, 0.477, 0.423, P<0.001), and was negatively correlated with TAPSE level (r =-0.551, P<0.001). After risk quantification in 103 PAH patients, we found that PWD was significantly different among the low-risk, moderate-risk and high-risk groups (43.89 ± 9.91 vs. 51.29 ± 6.61, 62.15 ± 10.44, P<0.001). CHD-PAH and IPAH were identified by PWD with a cut off value of 41.5ms (P< 0.001), and a cut off value of 41.45ms (P< 0.001), respectively. Conclusion: PWD might be an effective ECG indicator for PAH, which might be used as a relatively economical and easily accessible indicator for PAH patients to assist in early diagnosis, disease severity assessment and prognosis evaluation.
Drug-induced pulmonary arterial hypertension (PAH) has been widely reported but PAH caused by leflunomide is very rare. Here we report the case of a young man with nephrotic syndrome treated with leflunomide for 5 years before being admitted to our hospital for dyspnea. After discontinuing leflunomide treatment for 4 months, both the dyspnea and pulmonary artery systolic pressure improved. Right heart catheterization showed in a significant decrease in pulmonary vascular resistance and pulmonary artery pressure 4 months later. Because persistent PAH can lead to right heart failure and even death, identifying and excluding the risk factors is critical; discontinuing leflunomide until a definite cause is identified is highly recommended.
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