Vol. 5, Issue 2, Part A (2023)

Background: Pulmonary hypertension (PH) is a significant health concern in Iraq, known for its high morbidity and mortality rates and commonly associated with structural heart disease. This study aimed to examine the epidemiological characteristics of PH patients and evaluate the effectiveness of bosentan therapy at a specialized Iraqi center. 
Method: Conducted at Ibn-Albitar Center for Cardiac Surgery in Baghdad from September 2020 to June 2021, this cross-sectional study involved 244 patients with PH. Data collection involved direct interviews, questionnaires, and reviews of patient files, including detailed histories and laboratory tests such as liver function tests (LFT). 
Results: The mean age of the PH patients was 26.17 years, with the majority aged between 6-17 years. Females were more prevalent (74.6%) compared to males (25.4%), with a male to female ratio of 1:2.94. Pulmonary hypertension was classified into five groups, with Group 1 PAH (including 66.9% with congenital heart disease (CHD), 31.7% with idiopathic pulmonary arterial hypertension (IPAH), 0.8% with heritable pulmonary arterial hypertension (HPAH), and 0.4% with connective tissue disease (CTD)) comprising 96.72% of the patients. The study found that bosentan therapy led to an improvement in the 6-minute walk distance (6MWD) and a significant upgrade from functional class III to II in patients with IPAH (p=0.041). However, patients with CHD and those on bosentan for over five years experienced a decline in 6MWD (p=0.024 and p=0.043, respectively). 
Conclusion: PH is a prevalent and serious healthcare issue in Iraq, primarily caused by CHD, with large ventricular septal defects being the most common underlying condition. Bosentan therapy, while generally safe and well-tolerated, shows varying efficacy in improving 6MWT performance and functional class in patients with different types of PH.