Clinical Indicators for Pulmonary Arterial Hypertension in Thalassemia
Nonlawan Chueamuangphan MD*, Wattana Wongtheptien MD*, Weerasak Nawarawong MD**, Apichard Sukornthasarn MD**, Suporn Chuncharunee MD***, Chamaiporn Tawichasri MSc****, Jayanton Patumanond MD, DSc****
Affiliation : * Department of Medicine, Chiang Rai Hospital, Chiang Rai, Thailand ** Department of Medicine Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand *** Department of Medicine, Faculty of Medicine at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand **** Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To explore clinical indicators for pulmonary arterial hypertension (PAH) in thalassemia (Thal).
Material and Method: A study was conducted in thalassemia patients at Chiang Rai Hospital, Chiang Rai, Thailand.
Pulmonary artery systolic pressure (PASP) was determined by doppler echocardiography and PAH was defined as PASP > 35
mmHg. Patient characteristics were extracted from medical records. Characteristics of patients with and without PAH were
compared. Risk indicators were explored with logistic regression analysis.
Results : Two hundred twenty four patients were included, 144 E/β-Thal, 37 homozygous β-Thal and 43 Hb H disease.
There were 65 patients (29.0%) with PAH, 53 (81.5%) with E/β-Thal, 8 (12.3%) with homozygous β-Thal and 4 (6.2%) with
Hb H disease. In a multivariable analysis, features significantly associated with PAH were E/β-Thal (OR = 1.98, 95% CI;
1.29-3.01) and post splenectomy status (OR = 2.36, 95% CI; 1.17-4.73).
Conclusion : Significant indicators for PAH in thalassemia were E/β-Thal and post splenectomy status.
Keywords : Thalassemia, Pulmonary Arterial hypertension, Splenectomy
