Vascular compression and pulmonary hypertension: the occupational context

In this issue of Occupational and Environmental Medicine, Yu et al1 present findings from a study of 199 miners with progressive massive fibrosis (PMF). Patients at high or intermediate probability of having pulmonary hypertension (PH, n=79) were defined, for the purposes of this study, as having PH on echocardiogram in combination with secondary signs of PH.2 Patients were characterised by CT, and adjusted regression analysis identified that both large and central opacities were predictive of PH, and the authors assert that the mechanical obstruction to the proximal pulmonary vasculature may be aetiologically important. These findings further support the view that echocardiographic features of even mild elevation of PA pressure are associated with a worse prognosis,3 with those defined as having an intermediate or high probability of PH having a survival of 73.3% compared with 96.6% for the non-PH group over a median follow-up...
Source: Occupational and Environmental Medicine - Category: Occupational Health Authors: Tags: Commentary Source Type: research