Нуреrsensitivity pneumonitis combined with arterial hypertension: clinical, radiological, functional features

Abstract

The aim of the study was to explore the clinical, radiological, functional indicators of hypersensitivity pneumonitis (HP) in combination with arterial hypertension, to assess the effect of these diseases on each other.Methods. The study included 50 patients with hypersensitivity pneumonitis (HP) and 49 patients with arterial hypertension (AH). The patients were divided into three groups. The main group included 24 patients with hypersensitivity pneumonitis combined with AH. The comparison group was 26 patients with HP without AH; the control group was 25 patients with arterial hypertension alone. Clinical symptoms, radiological findings, and results of instrumental tests were analyzed.Results. The intensity of clinical symptoms (shortness of breath, cough) was significantly higher in the main group than in the control and comparison groups. Exercise tolerance estimated from the six-minute walk test was significantly lower in the main group. The clinical status correlated with the functional testResults. Volumetric and velocity spirometry values tended to decrease more in the main group compared to the other two groups. The lung diffusion capacity was significantly lower in the group of patients with HP in combination with AH compared to the group of patients with hypertension only. A similar trend was observed when assessing the chest CT: significantly more pronounced changes were found in the main group. EchoCG showed a significant increase in pulmonary hypertension and volumes of the right heart in the main group compared to the group of patients with AH alone.Conclusion. The present study provides evidence of the greater intensity of respiratory symptoms, decreased functional status, ventilation disorders, dilated heart cavities, greater risk of fatal vascular complications in patients with HP associated with hypertension.