Prevalence of Portopulmonary Hypertension in Patients with Chronic Liver Disease: A Cross-Sectional Comparative Study
Background: Portopulmonary hypertension (PoPH) is an uncommon complication of chronic liver disease (CLD) defined by mean pulmonary artery pressure (mPAP)≥ 25mmHg at rest, pulmonary vascular resistance (PVR)>240 dyne/sec/cm-5 in the presence of portal hypertension (PoH). Literature on its prevalence amongst CLD patients in Nigeria is scanty. Objective: To determine the prevalence of PoPH in patients with chronic liver disease Methods: Adult patients (≥18 years) diagnosed of CLD at the University of Calabar Teaching Hospital, Nigeria were recruited over a 10 month period from June 2018- April, 2019. The cases were age and sex matched with controls that had no symptoms or signs of CLD. All patients had trans-thoracic echocardiography (TTE). All parameters for the diagnosis of pulmonary arterial hypertension (PAH) were assessed based on recommendations of the American/ European Echocardiographic Association. Results: A total of 160 individuals participated in the study (80 cases of CLD and 80 healthy controls). The M: F ratio was 2.8:1. Hepatitis B virus infection was the aetiologic agent of CLD in 73.75% of cases. The mPAP was significantly higher in CLD patients (21.3 ± 10.1mm Hg versus 14.1 ± 7.6mm Hg; p 25mm Hg and 1.25% had PoPH. Thus, the prevalence of PoPH in this study was 1.25%. The estimated PVR and the systolic function of the right ventricle was not significantly different between the cases and the controls (p>0.05). Conclusion: The prevalence of PoPH is low in our CLD cohort and most of these patients were females with HBV-related CLD.
