| Journal: | Archivos de cardiología de México |
| Database: | PERIÓDICA |
| System number: | 000317284 |
| ISSN: | 1405-9940 |
| Authors: | Lupi Herrera, Eulo1 Sandoval Zárate, Julio Figueroa Solano, Javier Santos Martínez, Luis Efrén Pulido Zamudio, Tomás René Bautista Bautista, Edgar Gildardo |
| Institutions: | 1Instituto Nacional de Cardiología Ignacio Chávez, México, Distrito Federal. México |
| Year: | 2008 |
| Season: | Abr-Jun |
| Volumen: | 78 |
| Number: | 2 |
| Pages: | 148-161 |
| Country: | México |
| Language: | Español |
| Document type: | Artículo |
| Approach: | Experimental, caso clínico |
| Spanish abstract | Las clases I-II representan la "mayoría de los enfermos con HAP-I", hallazgo que es opuesto a lo considerado de manera tradicional. Sólo la PADm y la PAPm son diferentes entre las clases de la NYHA/WHO. La clasificación con fundamento en estos dos parámetros permite diferenciar a los enfermos de las clases I-II con los de las clases III-IV. Los enfermos en clase I tienen el mejor pronóstico y la mayor probabilidad de ser respondedores al reto vasodilatador agudo |
| English abstract | The most often used functional classification for categorizing the degree of cardiac disability in patients with chronic left ventricular failure is the NYHA/WHO system . In Idiopathic Pulmonary Arterial Hypertension [IPAH], this system although used, has not been studied in detail regarding pulmonary hemodynamic parameters association and for long-term prognosis in each of the NYHA/WHO classes. Methods: We retrospectively, studied the NYHA/ WHO system in 83 I-PAH patients. Patients were separated according to the response in the acute vasodilator trial in responders [n = 30] and nonresponders [n = 53]. Results: Classes I - II did not represent the minority population for IPAH patients [58/83 = 60%]. Only mean right atrial pressure [mRAP] and mean pulmonary artery pressure [mPAP] were different among the NYHA/WHO functional classes [p < 0.000 and p < 0.012; respectively]. I-PAH patients class I have the probability to be a responder 12.6 times more [CI 95.%: 4.59-40.62; p < 0.000]. The long-term mortality for class I patients was 0.%, for class II: 2.%, for class III: 28.% and for class IV: 63.% [p < 0.0001]. The follow-up change for one grade class of the NYHA/WHO classes at four years was noticed only in 20.% of the I-PAH patients. Conclusions: NYHA/WHO classes I-II did not represent the minority of IPAH patients population as has been previously considered. Only mRAP and mPAP were different among the NYHA/WHO classes. The NYHA/ WHO system on the basis of mRAP and mPAP allows to separate classes I-II from III-IV. I-PAH patients class I have 12.6 times more the probability to be a responder and better longterm survival; irrespective of the treatment the prognosis seems to be excellent for this functional class group patients |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Sistema cardiovascular, Hipertensión pulmonar, Clasificación, Insuficiencia cardiaca, Ventrículo izquierdo, Capacidad funcional, Hemodinámica |
| Keyword: | Medicine, Cardiovascular system, Diagnosis, Pulmonary hypertension, Classification, Heart failure, Left ventricle, Functional capacity, Hemodynamics |
| Full text: | Texto completo (Ver HTML) |
