Effect of pulmonary hypertension on outcome of pulmonary tuberculosis

Marjani, Majid; Baghaei, Parvaneh; Malekmohammad, Majid; Tabarsi, Payam; Kashani, Babak Sharif; Behzadnia, Neda; Mansouri, Davood; Masjedi, Mohammad Reza; Velayati, Ali Akbar

doi:10.1016/j.bjid.2014.02.006

Cited by 10 publications

(12 citation statements)

References 9 publications

(16 reference statements)

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“…Evidence describing cardiac pathology in PTB has important limitations: many studies are case reports or series with small sample sizes; and others are limited by signi cant selection bias where cardiac pathology is described in PTB patients with incident cardiac disease or in well-de ned subgroups, such as those with post-TB lung disease. (25)(26)(27)(28)(29)(30)(31) To our knowledge, this is the rst observational study to systematically establish the prevalence of and associations between cardiac pathology and newly-diagnosed PTB. We will use a range of modalities including state-of-the-art biochemical pro ling of cardiac injury and stretch supplemented with noninvasive imaging of the myocardium by ultrasound.…”

Section: Discussionmentioning

confidence: 99%

The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study

Scopazzini,

Chansa,

Shanaube

et al. 2024

Preprint

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Background: Tuberculosis (TB) continues to be a major cause of death across sub-Saharan Africa (SSA). In parallel, non-communicable disease and especially cardiovascular disease (CVD) burden has increased substantially in the region. Cardiac manifestations of TB are well-recognised but the extent to which they co-exist with pulmonary TB (PTB) has not been systematically evaluated. The aim of this study is to improve understanding of the burden of cardiac pathology in PTB in those living with and without HIV in a high-burden setting. Methods: This is a cross-sectional and natural history study to evaluate the burden and natural history of cardiac pathology in participants with PTB in Lusaka, Zambia, a high burden setting for TB and HIV. Participants with PTB, with and without HIV will be consecutively recruited alongside age- and sex-matched TB-uninfected comparators on a 2:1 basis. Participants will undergo baseline assessments to collect clinical, socio-demographic, functional, laboratory and TB disease impact data followed by point-of-care and standard echocardiography. Participants with PTB will undergo further repeat clinical and functional examination at two- and six months follow-up. Those with cardiac pathology at baseline will undergo repeat echocardiography at six months. Discussion: The outcomes of the study are to a) determine the burden of cardiac pathology at TB diagnosis, b) describe its association with patient-defining risk factors and biochemical markers of cardiac injury and stretch and c) describe the natural history of cardiac pathology during the course of TB treatment.

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Section: Discussionmentioning

confidence: 99%

The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study

Scopazzini,

Chansa,

Shanaube

et al. 2024

Preprint

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“…Spirometric measures of lung damage (reduced FVC, FEV 1 and FEV 1 /FVC ratio), although common, were surprisingly not associated with the finding of probable PH, neither was 6MWD, age or HIV status. Marjani et al, 12 found 9% of 777 patients admitted with TB to have PH on TTE, however, they assessed patients at the time of TB treatment and only included patients with disease severe enough to warrant inpatient treatment, thus limiting the applicability to both less severe as well as post-TB patients. Although right heart catheterization is the gold standard to establish the diagnosis of PH, this is not commonly available in low-tomiddle income countries and it therefore remains an important noninvasive screening tool.…”

Section: Discussionmentioning

confidence: 99%

“…PH was found in almost 10% of new hospitalized cases of acute pulmonary TB and was associated with a threefold increase in in‐hospital mortality 12 . It is uncertain if PH may evolve or improve in the posttreatment period or even develop years after the initial episode of TB.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11] PH was found in almost 10% of new hospitalized cases of acute pulmonary TB and was associated with a threefold increase in in-hospital mortality. 12 It is uncertain if PH may evolve or improve in the posttreatment period or even develop years after the initial episode of TB. PH-postTB has been described since the 1950s, 13 however, much of the literature on PH-postTB predates the 1980s and was conducted even before the advent of effective chemotherapeutic agents.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of pulmonary hypertension after successful tuberculosis treatment in a community sample of adult patients

et al. 2023

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There are an estimated 155 million survivors of tuberculosis (TB). Clinical experience suggests that post tuberculosis lung disease (PTLD) is an important cause of Group 3 pulmonary hypertension (PH). However, TB is not listed as a cause of PH in most guidelines. A cross‐sectional, community‐based study was conducted in nonhealthcare seeking adults who had successfully completed TB treatment. Subjects underwent questionnaires, spirometry, a 6‐min walk distance test (6MWD) and transthoracic echocardiography (TTE). Screen probable PH was defined on TTE as an estimated pulmonary artery peak systolic pressure (PASP) of ≥40 mmHg. One hundred adults (71 males) were enrolled, with a mean age of 42 years ( SD 13.8 years) and a median of one TB episode (interquartile range: 1–2). Co‐morbidities included hypertension (21%), diabetes (16%), human immunodeficiency virus (10%) and asthma/COPD (5%). Only 25% had no residual symptoms after TB. Probable PH was found in 9%, while 7% had borderline raised PASP values (PASP 35–40 mmHg). An association was found between PH and the number of previous TB episodes, with each additional episode of TB increasing the odds of PH‐postTB 2.13‐fold (confidence interval [CI]: 1.17–3.88; p = 0.013). All of those found to have PH were smokers or ex‐smokers yielding an unadjusted odds ratio for PH‐postTB of 3.67 (95% CI: 0.77–17.46). There was no statistical difference in spirometry or 6MWD, between those with and without PH. Neither symptoms nor co‐morbidities demonstrated significant association with PH. PH after TB was a common finding in this community‐based population. Further research is needed to confirm and determine the significance of these findings.

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“…PH secondary to PTB receives little attention. A previous study showed that PH was significantly associated with mortality among active PTB patients (Marjani et al, 2014). Therefore, early detection of elevated pulmonary artery pressure in active phase of PTB and intervention of correlated factors may help to improve treatment outcome for PTB patients.…”

Section: Introductionmentioning

confidence: 96%

Arterial partial pressure of oxygen and procalcitonin levels correlate with pulmonary artery systolic pressure in patients with active pulmonary tuberculosis

Wenting

Chang-Wei

Bian

et al. 2022

International Journal of Infectious Diseases

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Effect of pulmonary hypertension on outcome of pulmonary tuberculosis

Abstract: A significant association was found between mortality and presence of pulmonary hypertension and drug abuse among new cases of pulmonary tuberculosis.

Cited by 10 publications

References 9 publications

The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study

The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study

The prevalence of pulmonary hypertension after successful tuberculosis treatment in a community sample of adult patients

Arterial partial pressure of oxygen and procalcitonin levels correlate with pulmonary artery systolic pressure in patients with active pulmonary tuberculosis

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