Pulmonary arterial hypertension (PAH) is a rare and incurable disease affecting people of all ages. It is characterized by obstructive remodeling of the small pulmonary arteries, responsible for an increase in pulmonary arterial pressure, leading to right heart failure and death in the absence of treatment. PAH can be associated with a variety of diseases, but around half of all PAH cases are idiopathic or hereditary, and may develop on predisposed terrain following a "second hit", as suggested by the identification of PAH cases associated with the use of anorectic drugs, methamphetamine and occupational exposure to organic solvents. No study has systematically analyzed the exposome of patients with PAH, combining environmental and occupational exposures as well as drugs and medications. The exposome of patients with PAH without associated causes will be compared with that of patients with another form of pulmonary hypertension (PH), linked to thromboembolic risk factors: chronic thromboembolic PH (CTEPH), which will constitute the control group.
Study Type
OBSERVATIONAL
Enrollment
150
Patients will complete questionnaires on professional exposures with the help of a trained professional (estimated time: 30 minutes), followed by self-questionnaires on indoor and outdoor pollution, medications, drugs and socio-economic variables (estimated time: 30 minutes).
Two strands of hair (or beard or axillary hair) will be taken, along with a urine and blood sample.
Bordeaux University Hospital
Bordeaux, France
Brest University Hospital
Brest, France
Le Kremlin Bicetre Hospital
Le Kremlin-Bicêtre, France
Lille University Hospital
Lille, France
Louis Pradel Hospital
Lyon, France
Nancy University Hospital
Nancy, France
Poitiers University Hospital
Poitiers, France
Saint Etienne University Hospital
Saint-Etienne, France
New Civil Hospital
Strasbourg, France
Larrey Hospital
Toulouse, France
To compare the exposome assessed based on the concentration of 190 environmental toxins, drugs and medications of interest in the hair and urine of patients newly diagnosed with PAH or CTEPH
Time frame: From enrollement to the end of study at day 1
To compare the exposome of patients newly diagnosed with PAH or CTEPH in terms of outdoor and indoor environmental exposures
Compare indoor and outdoor exposure questionnaires as well as the EPICES socioeconomic assessment questionnaire. Compare environmental exposures using a composite score of indoor and outdoor pollution. Compare concentrations of NO₂, PM10, and PM2.5 to pollutants assessed based on patients' addresses. Compare broad-based screening of hair and urine for the presence of environmental toxins.
Time frame: From enrollement to the end of study at day 1
To compare the exposome of patients newly diagnosed with PAH or CTEPH in terms of occupational exposures
Compare the results of work schedules based on standardized questionnaires. Compare the results of job-exposure matrices applied to work schedules.
Time frame: From enrollement to the end of study at day 1
To compare the exposome of patients newly diagnosed with PAH or CTEPH in terms of medications exposures
Compare the medication history corresponding to a 2-year exposure assessment for each drug studied.
Time frame: From enrollement to the end of study at day 1
To compare the exposome of patients newly diagnosed with PAH or CTEPH in terms of drug exposures
Compare substance use questionnaires. Compare questionnaires on substance use disorders. Compare questionnaires on associated risky behaviors. Compare broad-range drug screening of hair and urine.
Time frame: From enrollement to the end of study at day 1
Céline ABONNEAU, Project manager
CONTACT
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