Pulmonary hypertension in patients with myeloproliferative neoplasms: A large cohort of 183 patients

Eur J Intern Med. 2019 Oct:68:71-75. doi: 10.1016/j.ejim.2019.08.004. Epub 2019 Aug 14.

Abstract

Background: Chronic myeloproliferative neoplasms (MPN) are recognized as a cause of pulmonary hypertension (pH). We ought to describe the prevalence and characteristics of PH in a cohort of MPN who were screened using transthoracic echocardiography (TTE).

Methods: One hundred eighty-three newly diagnosed consecutive MPN patients were prospectively evaluated using TTE to detect PH.

Results: Two patients were diagnosed with chronic eosinophilic leukemia, two patients had post-essential thrombocythemia (ET) myelofibrosis (MF), two patients had post-polycythemia vera (PV) MF, 11 patients had primary myelofibrosis (PMF), 28 patients had chronic myeloid leukemia (CML), 51 patients had PV, and 87 patients had ET. TTE was used to determine PH, and PH was suspected in 16 of 183 patients as follows: four with PV, seven with ET, two with PMF, and three with CML. Two patients with ET were excluded because of global cardiac failure. Three patients underwent right heart catheterization to confirm PH. The 14 (7.7%) patients with PH had no cardiac or lung disease that directly involved MPN in PH development.

Conclusion: In this large cohort of 183 MPN patients, TTE was used to diagnose PH, and 14 patients (7.7%) developed PH. This prevalence was lower than expected based on previously reported data, but it remains higher than in the general population.

Keywords: Chronic myeloproliferative neoplasms; Pulmonary hypertension; Transthoracic echocardiography.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Marrow Neoplasms / complications*
  • Cardiac Catheterization
  • Echocardiography
  • Female
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / epidemiology
  • Hypertension, Pulmonary / etiology*
  • Male
  • Middle Aged
  • Young Adult