Around the globe: Global burden of pulmonary hypertension

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27 January 2021

  • days
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  • Minutes

Chair and moderators

Paul Corris, University of Newcastle, UK
Stylianos Orfanos, University of Athens Medical School, Greece
Rogerio Souza, University of Sao Paulo, Brazil
Helen Whitford, The Alfred Hospital, Australia

 

Agenda

  • Fausto Pinto // The view of the World Heart Federation (WHF)
  • Ana Olga Mocumbi // Role of WHO/NCDA in promoting global health with a focus on cardiovascular disease
  • Sophia Emmons-Bell // Update on the Global Burden of PH Project of the Institute for Health Metrics and Evaluation (IHME)
  • Werner Seeger // PVRI GoDeep: Perspectives of a global meta-registry
  • Anggoro Budi Hartopo // Mortality of idiopathic/hereditary and connective tissue disease-associated pulmonary arterial hypertension: the data from first single center prospective registry in Indonesia
  • Humberto Garcia-Aguilar // Triple therapy in pulmonary arterial hypertension in an expert centre in Mexico City. Real-life results.

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A deeper look

Our first webinar, ‘Around the globe: Global burden of pulmonary hypertension’ (PH) will highlight the prevalence of PH and challenges to achieve a comprehensive global perspective of the disease. PH is often mis-diagnosed and is estimated to affect between 2.6 and 20% of hospitalised patients, corresponding to millions worldwide. The World Heart Federation has a goal to tackle the lack of awareness and is represented by Fausto Pinto. In Africa, PH burden is higher than in the developed countries. Risk factors among Africans have a higher abundance and variability, requiring an adjustment of clinical standards. Ana Mocumbi, Ministry of Health, Mozambique will describe PH in the context of the African population. After, we will get an update on the Global Burden of PH Project of the Institute for Health Metrics and Evaluation (IHME), by Sophia Emmons-Bell. Our final speaker, Werner Seeger, will discuss the PVRI-GoDeep project that aims to collect anonymised patient data from PH registries willing to participate, creating a global meta-registry covering all continents. This will offer insights into specific geographical and ethnical profiles of PH, as well as facilitating new clinical standards. The webinar will be concluded by insights from PH experts in Mexico and Indonesia.

 

The view of the World Heart Federation (WHF)
15:00 GMT

Presenter: // Fausto Pinto Lisbon Medical School, Portugal and World Heart Federation President 2021-22

Pulmonary hypertension (PH) is a clinical hemodynamic condition that results from a surprisingly large number of disease processeswidely under-recognised due to a lack of awareness and understanding even amongst the medical community. All age groups can be affected with rapidly growing importance in elderly people, particularly in countries with ageing populations. In recent years we have come a long way in our understanding of PH. As a result of ever-increasing experience in treating pulmonary arterial hypertension and chronic thromboembolic PH, and the availability of new treatment options, there have been continual improvements in patient outcomes. Unfortunately, until now there is no accurate global data on the prevalence of the disease. It is estimated that over 100 million people suffer from PH, although this figure is considered as an underestimation. The World Heart Federation (WHF), from which PVRI is a member, is a global organization in official relations with WHO, deeply committed to work together with our members to improve knowledge about different cardiovascular conditions. Therefore, it is our wish at WHF to have a closer interaction with PVRI in order to further improve the awareness on this serious clinical condition, improving all aspects related with its prevention, diagnosis and treatment.​

 

Role of WHO/NCDA in promoting global health with a focus on cardiovascular disease 
15:22-15:37 GMT

Presenter: // Ana Olga Mocumbi, Associate Professor of Cardiology in the Faculty of Medicine at Eduardo Mondlane University

Africa is home to a considerable proportion of the poorest billion people worldwide and is far from achieving many developmental targets linked to better health and longevity. Cardiopulmonary health in particular is compromised due to epidemiological transition, urbanisation, persistently high levels of infectious disease and high exposure to indoor air pollution. Considering the disproportionate socio-economic burden and health impact of COVID-19 on the African continent, there is concern regarding an additional likelihood of yet another risk of permanent damage to their heart and lungs in those infected.

In the absence of systematic disease surveillance systems in the poorest and most vulnerable populations in Africa, few hospital-based studies have unveil the causes, profile and outcomes of pulmonary vascular disease and right heat failure. The ‘Pan-African Pulmonary Hypertension Cohort Study’ revealed a singular pattern of antecedent disease, very poor health outcomes, and clear opportunities to improve prevention, diagnosis and management of pulmonary vascular disease in the continent. Prior studies had shown surprisingly high numbers of right heart failure, predominantly in women and unrelated to tobacco.

We review the data available on this subject to:

  1.  Describe the unique pattern and the challenges for the management of right heart failure (and its comorbidities) in Africa
  2.  Suggest strategies to improve early diagnosis and management; and iii) explore tailored approaches to leverage current efforts to understand and respond to the enormous burden imposed by cardiopulmonary disease in the continent

Finally, we discuss the role that global and regional organizations such as the World Health Organisation, NCD Alliance, World Heart Federation, Pan African Society of Cardiology play in promoting global health with a focus on cardiovascular disease.

 

Update on the Global Burden of PH Project of the Institute for Health Metrics and Evaluation (IHME) 
15:45-16:00 GMT

Presenter: // Sophia Emmons-Bell INSTITUTE FOR HEALTH METRICS AND EVALUATION (IHME), USA

The Global Burden of Disease (GBD) study is a multi-national effort to produce comparable, consistent measures of disease burden for all geographic locations, ages, sexes, and years since 1990. In its 2020 iteration, the GBD study will include pulmonary arterial hypertension (PAH) and report prevalence, incidence, and mortality rates of this rare disease. This includes identifying all population-representative estimates of PAH; estimating and correcting systematic bias in data sources; and using statistical models to identify geographical trends, temporal trends, and relationships between PAH and covariates. This talk will discuss preliminary estimates from the GBD 2020 study, expected to be released in Spring 2021.  

 

PVRI GoDeep: Perspectives of a global meta-registry
16:08-16:23 GMT

Presenter: // Werner Seeger JUSTUS-LIEBIG UNIVERSITY GIESSEN, GERMANY

PVRI is currently setting up the PVRI Global Deep Phenotyping PH Meta-Registry (PVRI-GoDeep), with the following objectives:

  1. To profit from established PH registries of PVRI members in all parts of the world, who remain proprietors of their registries but are willing to feed their data into this global “Meta-Registry”.
  1. To include all PH classes and subgroups, to record all essential phenotypic data and to assess treatment concepts and clinical follow-up.
  2. To expand this common trunk by facultative specialized modules collecting further deep phenotyping/genotyping data (genetics, epigenetics, *omics, advanced imaging, wearable device-based monitoring and/or miniaturised point-of-care self-testing), which may initially be fed only by subgroups of centers, but in the long run provide an invaluable basis to approach individualization of PH treatment on a much more sophisticated basis than currently possible.
  3. To establish a periodical electronic interface-based automated data update from the local registries into the Meta-Registry, thereby to avoid imposing any additional workload for the local registries once the interface is established.
  4. To provide PVRI with a) by far the largest deep phenotyping PH data bank worldwide, b) the only deep phenotyping PH data bank spanning over all continents, thereby offering insights into specific geographical and ethnical profiles of this disease, c) to become the go-to place for PH clinical and basic scientists focusing on pulmonary vascular diseases around the world.

Best abstract

16:30-16:40

Presenter: // Anggoro Budi Hartopo

Abstract topic: // Mortality of idiopathic/hereditary and connective tissue disease-associated pulmonary arterial hypertension: the data from first single center prospective registry in Indonesia

Best abstract

16:45-16:55

Presenter: // Humberto Garcia-Aguilar

Abstract topic: // Triple therapy in pulmonary arterial hypertension in an expert centre in Mexico City. Real-life results.

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