Severity of pulmonary artery hypertension among patients of obstructive airway disease attending rural-based hospitals: A cross-sectional study.

Abstract

Pulmonary artery hypertension (PAH) is a severe complication of obstructive airway diseases (OADs), leading to right heart dysfunction and increased morbidity and mortality. Elevated pulmonary pressures above 20 mmHg predict poor outcomes, emphasizing the need for early diagnosis and treatment. This study examines the correlation between PAH severity and OAD, aiming to inform targeted therapies. This cross-sectional observational study included OAD patients attending the Respiratory Medicine Department at PIMSR, Vadodara, from March 2023 to March 2024. Pulmonary function was assessed via spirometry per ATS/ERS guidelines, and PAH was graded using transthoracic echocardiography. Statistical analysis included the <i>Z</i> test for continuous data and Chi-square or Fisher's exact test for nominal data, with significance set at <i>P</i> < 0.05. Spirometry revealed average FEV1 (%) of 74.3 ± 13.6 with values of (2.9L ± 0.13L), FVC (%) of 95.5 ± 6.0 with values of (3.72L ± 0.89L), and FEV1/FVC of 77.6 ± 12.4. Post-TB OAD patients had the lowest values (FEV1), while asthma patients had the highest (FEV1). Mild PAH was observed in 42 (52.5%) OAD patients, 23 (28.8%) have moderate PAH, and 15 (18.8%) have severe PAH. A significant association (<i>P</i> < 0.001) was observed between airflow obstruction severity and PAH severity. Severe airflow obstruction correlated with severe PAH, while mild obstruction aligned with mild PAH. Post-TB OAD had the highest proportion of severe PAH, with PAH severity increasing as airflow obstruction worsened.