Clinical and hemodynamic evaluation of schistosomiasis-associated pulmonary arterial hypertension from Egyptian pulmonary hypertension centers: epidemiology, risk factors, and survival determinants.

Sch-PAH patients were significantly older and predominantly male compared to IPAH patients.

• Sch-PAH patients had a mean age of 50.4 ± 12 years versus 34.5 ± 9.7 years for IPAH patients.
• Male predominance was statistically significant in the Sch-PAH group (P < 0.001).
• The cohort included 41 Sch-PAH and 42 IPAH patients studied retrospectively over five years (2019–2024) from 3 pulmonary hypertension centres in Egypt.

Sch-PAH patients had higher comorbidity rates, chiefly chest and hepatic disorders, compared to IPAH patients.

• Higher rates of chest and hepatic disorders were observed in the Sch-PAH group.
• The Sch-PAH group exhibited more WHO functional class IV cases (P = 0.007).
• Data collection focused on demographic details, comorbidities, echocardiographic findings, and survival rates.

Sch-PAH patients showed greater left atrium and pulmonary artery dilation compared to IPAH patients.

• Greater left atrium (LA) dilation was observed in the Sch-PAH group (P = 0.006).
• Greater pulmonary artery (PA) dilation was also observed in the Sch-PAH group (P = 0.01).
• These echocardiographic differences were statistically significant between the two groups.

Lower ejection fraction, absence of PA dilation, and absence of portal hypertension were linked to improved survival in Sch-PAH.

• Ejection fraction percentage (EF%) emerged as an independent survival predictor with odds ratios of 0.72 and 0.55 (P = 0.002 and P < 0.001, respectively).
• Absence of PA dilation was associated with improved survival.
• Absence of portal hypertension was also associated with improved survival.
• These factors were evaluated in the context of a five-year retrospective cohort study.

An EF% cutoff below 66% demonstrated high predictive accuracy for survival in Sch-PAH patients.

• The EF% cutoff below 66% showed an AUC of 0.85 (P = 0.008).
• This cutoff was described as showing 'high predictive accuracy for survival.'
• EF% was identified as an independent survival predictor across multivariate analysis.

Schistosomiasis-associated PAH is classified under group I pulmonary hypertension and represents a significant global public health burden.

• Schistosomiasis affects approximately 230 million people, mainly in sub-Saharan Africa.
• Sch-PAH falls under group I pulmonary hypertension.
• The study notes that 'its prevalence poses a public health challenge, making the identification of mortality predictors crucial for early patient risk assessment and improved prognosis management.'