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Oxygen therapy in CTEPH patients: prevalence and associated factors
Session:
SESSÃO DE POSTERS 13 - CONGÉNITOS E HTP 1
Speaker:
Tiago Lobão
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Tiago Miguel Raposo Lobão; Bárbara Ferreira; Sofia Alegria; Filipa Ferreira; Débora Repolho; Liliana Brochado; Diogo Cunha; Oliveira Baltazar; João Luz; Nazar Ilchyshyn; Lourenço Aguiar; Hélder Pereira
Abstract
<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction:</strong> Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by elevated mean pulmonary artery pressure (mPAP) due to persistent obstruction of the pulmonary vasculature by organized fibrotic material. This condition is associated with significant morbidity and mortality. In patients with resting hypoxemia, need for long-term oxygen therapy (LTOT) is indicated (paO2 < 60 mmHg). However, studies on the prevalence and factors associated with the need for LTOT in this population are still scarce.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Purpose:</strong> To characterize patients with CTEPH who are under LTOT and the factors associated with hipoxemia in this population. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methodology:</strong> A retrospective study from a referral center for pulmonary hypertension was conducted. All patients with CTEPH who began follow-up in the clinic between 2015 and 2023 were included. Relevant baseline clinical, laboratory, echocardiographic, hemodynamic assessments, respiratory function tests, and pulmonary scintigraphy data were colected. The following tests were used: chi-square test, Mann-Whitney U test, and univariate logistic regression. Continuous data were presented as median and interquartile range (IQR).</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> Of the 67 patients included in this study, 25 (37%) were on LTOT therapy. The majority were women (72%), with a median age of 72 years (IQR 59.5-79), mostly presenting in NYHA functional class III (60%), with an NT-proBNP of 1995 (IQR 920.5-3716.5), and 76% had a history of pulmonary embolism in the past. The following characteristics were associated with an increased likelihood of requiring O2 (without LTOT vs with LTOT): NYHA functional class IV [4.9 vs 40%; p < 0.001; OR 13 (95% CI 2.6-66.4)]; six-minute walk test [360 (275-440) vs 240 (135-365); p = 0,003; OR 0,0991 (95% CI 0,985-0,997)]; right atrial dilation [51.2% vs 92%; p < 0.001; OR 10.952 (95% CI 2.280-52.608)]; right ventricular dilation [57.1% vs 84%; p = 0.024; OR 3.937 (95% CI 1.149-13.492)]; decreased sistolic longitudinal function of the RV [20 (16-23) vs 17 (14-19); p = 0.024; OR 0.875 (95% CI 0.769-0.996)]; estimated pulmonar artery sistolic pressure [67 (IQR 47-94.5) vs 100 (IQR 88.5-112); p < 0.001; OR 1.041 (95% CI 1.017-1.065)]; mPAP [37 (26.5-51.5) vs 47 (45-54); p = 0.03; OR 1.078 (95% CI 1.026-1.133)]; RVP [6.4 wood U (3.86-10.605) vs 11.25 (9.02-15.6); p < 0.001; OR 1.206 (95% CI 1,069-1,360)]; cardiac index [2.375 (2.050-2.8175) vs 2.0 (1.6-2.42); p = 0.013; OR 0.377 (95% CI 0.156-0.911)]; ; SvO2 [66.7% (62.3%-72.7%) vs 60% (52.9%-66.1%); p = 0.001; OR 0.894 (95% CI 0.830-0.963)]. Our study did not demonstrate statistically significant differences between groups regarding DLCO assessment, percentage of perfusion defects in scintigraphy or NT-proBNP values.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion:</strong> These results highlight that a significant proportion of CTEPH patients need LTOT. This seems to correlate with disease severity including hemodynamic parameters.</span></span></p>
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