EFFICACY OF MULTIDISCIPLINARY MANAGEMENT OF PULMONARY HYPERTENSION

Abstract

Aim. To assess the efficacy of regional system of multidisciplinary care in pulmonary hypertension (PH).Material and methods. In a single-center, pro and retrospective cohort study, 2001-2015, the epidemiological characteristics and yearly mortality from PH were assessed in the created in late 1990s multiple system of PH management in the Udmurt Republic. According to the specific drug therapy tactics, there were three periods of observation: in 2001-2005 PH patients received, by indication calcium channel blockers and supportive therapy; in 2006-2010 sildenafil was added; from 2011 pulmonary arterial hypertension (PAH) patients also received bosentan, ambrisentan, and in chronic thromboembolic PH —inhaled iloprost.Rеsults. In the cardiology and rheumatology clinic of the Udmurt Republic, a multidisciplinary system of PH management was shaped, with three-stage individualized care of patients, beginning from newborn period (1st stage — pre-hospital, 2nd — hospital, 3rd — rehabilitation). Within the first 5 years of follow-up, mortality of PH patients was 15-12% per year, from 2006 to 2010 — 10-7,5% per year, in 2011-2015 — 5,6–3,8% (р2015-2001=0,008).Conclusion. Interprofessional approach to PH patients care in thecircumstances of regional center and therapy by PAH-specific drugs significantly increased survival rate of patients.

Keywords

• pulmonary hypertension
• multidisciplinary management
• bosentan
• sildenafil
• riociguat
• macitentan
• selexipag