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This significant burden has prompted studies on the clinical characteristics and outcomes of Sch-PAH to improve awareness and management, particularly in developing regions. This study investigates the characteristics of Sch-PAH, including demographics, clinical and hemodynamic features, and survival outcomes compared to idiopathic Pulmonary arterial hypertension (IPAH), while evaluating the prognosis and current clinical practices. A cohort of 83 patients, including 41 with Sch-PAH and 42 with IPAH, were studied retrospectively over five years (2019\u20132024) from 3 pulmonary hypertension centres in Egypt. Data collection focused on demographic details, comorbidities, echocardiographic findings, and survival rates. Sch-PAH patients were significantly older (50.4\u2009\u00b1\u200912\u00a0years) and predominantly male (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001) compared to IPAH patients (34.5\u2009\u00b1\u20099.7\u00a0years). Higher comorbidity rates, chiefly chest and hepatic disorders, were observed in Sch-PAH. The Sch-PAH group exhibited more WHO functional class IV cases and greater left atrium (LA) and pulmonary artery (PA) dilation (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.007,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.006,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.01, respectively). Lower ejection fraction (EF%) and absence of PA dilation and portal hypertension were linked to improved survival, with EF% emerging as an independent survival predictor (OR\u2009=\u20090.72 and 0.55;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.002 and\u2009&lt;\u20090.001). The EF% cutoff below 66% showed high predictive accuracy for survival (AUC\u2009=\u20090.85,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.008). Sch-PAH affects primarily older males with significant comorbidities. Its prevalence poses a public health challenge, making the identification of mortality predictors crucial for early patient risk assessment and improved prognosis management.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-41412-7","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T15:52:56Z","timestamp":1774108376000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and hemodynamic evaluation of schistosomiasis-associated pulmonary arterial hypertension from Egyptian pulmonary hypertension centers: epidemiology, risk factors, and survival determinants"],"prefix":"10.1038","volume":"16","author":[{"given":"Youssef M. 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