Venous Thromboembolism and Persistent Pulmonary Hypertension in Cancer Patients: A Cross-Sectional Study
Siegfried Wieshammer, Jens Dreyhaupt, Dirk Müller, Felix Momm and Andreas Jakob
In a prospective study of patients with a history of cancer or other active malignant disease, researchers suggested a link between the formation of blood clots in leg, known as venous thromboembolism (VTE) and pulmonary hypertension (PH) which is a type of high blood pressure affecting the heart or lungs. It is important to note that cancer patients are at a heightened risk of developing these blood clots in the leg, and therefore may also be at risk for subsequent pulmonary hypertension. Often, shared symptoms between cancer and PH, such as fatigue and dyspnea, can lead to an oversight in detecting high blood pressure. As such, this study aimed to look at the effects of VTE as a potential risk factor for PH in cancer patients. Over 500 patients were assessed in the study, undergoing a full heart and lung diagnostic work-up and PH was diagnosed using echocardiography. The researchers found 90 patients with pulmonary hypertension and 72 patients with VTE. Analysis suggests that among cancer patients, a history of VTE was associated with a two-fold increase in developing PH. However, it is important to recall that in order to be included in the study, a patient must have been experiencing pulmonary or cardiac symptoms. Therefore, a patient with VTE who did not develop pulmonary hypertension was less likely to be referred to the study group because he or she would not have presented the relevant symptoms. As such, while the study did find a link between venous thromboembolism and eventual pulmonary hypertension in cancer patients, the findings cannot be generalized to the non-cancer patients or those who do not present pulmonary or cardiac symptoms due to the bias in the referral process.