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Pulmonary Medicine
Volume 2018, Article ID 7056360, 7 pages
Research Article

Pulmonary Arterial Hypertension Specific Therapy in Patients with Combined Post- and Precapillary Pulmonary Hypertension

1Section of Pulmonary Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
2Division of Cardiology, Department of Medicine, McGill University, Montreal, QC, Canada
3King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia

Correspondence should be addressed to Zoheir Bshouty;

Received 24 October 2017; Revised 7 December 2017; Accepted 26 December 2017; Published 1 March 2018

Academic Editor: Dimitris Georgopoulos

Copyright © 2018 Hassan Alfraidi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Specific therapy for patients with PAH is associated with good outcomes. Little is known about the effect of this treatment in patients with Cpc-PH (PAPm ≥ 25 mmHg, PAWP > 15 mmHg, DPG ≥ 7 mmHg, and/or PVR > 3 WU). This study evaluates the outcome of treating patients with Cpc-PH using PAH specific therapy. Methods. The primary outcome was survival. Secondary outcomes were WHO functional class and 6-minute walk distance (6-MWD). Results. Twenty-six patients with Cpc-PH (half with VHD and half with HF) received PAHST. Six patients did not tolerate treatment due to pulmonary edema. No predictors for treatment intolerance were identified. In twenty patients who tolerated the treatment, the mean WHO functional class improved from at initial assessment to () and () at 6 and 9 months, respectively. Mean 6-MWD improved from meters at initial assessment to meters () and meters () at 6 and 9 months, respectively. Twelve patients died during the follow-up period. Mean survival for all patients was days. Conclusion. PAHST may be beneficial in the treatment of Cpc-PH (both short and long term). Prospective randomized controlled trials of PAHST in this population are needed to assess its potential efficacy.