24 Clinical characteristics of patients with pulmonary hypertension in a developing middle eastern country: the first cohort of a national registry

Introduction Pulmonary hypertension imposes significant global health and socioeconomic burden due to the resultant morbidity and mortality. Clinical characteristics and outcomes of pulmonary hypertension varies from one country to another, with promising outcomes in well-established pulmonary hypertension centres. Nonetheless, developing Middle Eastern countries, such as Jordan, lack pulmonary hypertension centres due to a multitude of factors, especially the lack of data on the baseline characteristics of pulmonary hypertension patients. Methods Comprehensive data on patients with suspected pulmonary hypertension presenting to a tertiary university-based centre during the period of January 2014-December 2022 was retrieved. Subsequently, patients with confirmed pulmonary hypertension on right heart catheterisation were enrolled as the first cohort of a national pulmonary hypertension registry that acts as the fundamental step towards the establishment of nationwide pulmonary hypertension centre. Statistical analysis was performed to determine the clinical characteristics of the first cohort. Results A total of 25 patients were diagnosed with pulmonary hypertension on right heart catheterisation with a female gender predominance of 80% and a mean age of 55 ± 16.4 years old. Hypertension and diabetes were the most prevalent co-morbidities identified in approximately 48% and 24% of the patients, respectively. Moreover, 20%, 16% and 8% of the patients had confirmed diagnoses of deep vein thrombosis/pulmonary embolism, interstitial lung disease and obstructive sleep apnoea ,respectively. On echocardiographic examination, 60% had moderate (grade II) tricuspid regurgitation and 20% had severe (grade III) tricuspid regurgitation. Additionally, 16% had mitral regurgitation and 4% had aortic stenosis. On right heart catheterisation, mean left atrial diameter was 3.8 ± 0.67 cm, while the mean left ventricle systolic and diastolic diameters were 3.0 ± 0.63 cm and 4.8 ± 0.57 cm, respectively. Furthermore, the average mean right atrial pressure was 12.7 ± 7.4 mmHg and the mean systolic pulmonary arterial pressure was 67.5 ± 36.2 mmHg, whereas the mean diastolic pulmonary pressure was found to be 27.8 ± 13.8 mmHg. The mean pulmonary capillary wedge pressure was determined to be 15.8 ± 8.4 mmHg. Conclusion The mean age of patients at the time of diagnosis with pulmonary hypertension in Jordan appears to be similar to international trends and findings. However, an alarmingly elevated mean of systolic pulmonary arterial pressure has been identified that potentially indicates a delay in the diagnosis. Therefore, the presenting data further reinforces on the importance of enrolling subsequent cohorts in this national registry with the ultimate goal of establishing a national pulmonary hypertension centre. Conflict of Interest N/A