Update of screening and diagnostic modalities for connective tissue disease-associated pulmonary arterial hypertension.


Journal

Seminars in arthritis and rheumatism
ISSN: 1532-866X
Titre abrégé: Semin Arthritis Rheum
Pays: United States
ID NLM: 1306053

Informations de publication

Date de publication:
06 2019
Historique:
received: 16 07 2018
revised: 06 09 2018
accepted: 09 10 2018
pubmed: 13 11 2018
medline: 21 4 2020
entrez: 13 11 2018
Statut: ppublish

Résumé

Pulmonary arterial hypertension (PAH) has high morbidity and mortality in connective tissue diseases (CTDs), especially systemic sclerosis (SSc). In this systematic review, we provide an update on screening measures for early detection of PAH in CTD. Manuscripts published between July 2012 and October 2017, which incorporated screening measures to identify patients with PAH by right heart catheterization, were identified. Risk of bias was assessed using the QUADAS-2 tool. The systematic review resulted in 1514 unique citations and 22 manuscripts were included for final review; the majority of manuscripts had a lower risk of bias based on the QUADAS-2 tool. There were 16 SSc cohort studies and 6 case-control studies (SSc 4, SLE 2). Four SSc cohort studies evaluated transthoracic echocardiography (TTE) only. Eight SSc cohort studies evaluated composite measures including ASIG, DETECT, and a combination of tricuspid regurgitation velocity (TRV) and PFT variables. DETECT and ASIG had greater sensitivity and negative predictive value (NPV) compared to the 2009 ESC/ERS guidelines in different cohorts. The addition of PFT variables, such as DLCO or FVC/ DLCO ratio, to TRV, resulted in greater sensitivity and NPV compared to TRV alone. Current screening for PAH in CTDs is centered on SSc. Data continues to support the use of TTE and provides additional evidence for use of composite measures.

Identifiants

pubmed: 30415942
pii: S0049-0172(18)30446-3
doi: 10.1016/j.semarthrit.2018.10.010
pmc: PMC7155785
mid: NIHMS1563200
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1059-1067

Subventions

Organisme : NIAMS NIH HHS
ID : K24 AR063120
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR070470
Pays : United States
Organisme : NIAMS NIH HHS
ID : T32 AR007080
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2018. Published by Elsevier Inc.

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Auteurs

Amber Young (A)

Division of Rheumatology, Scleroderma Program, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Vivek Nagaraja (V)

Division of Rheumatology, Scleroderma Program, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Mark Basilious (M)

University of Michigan Undergraduate Program, Ann Arbor, MI, USA.

Mirette Habib (M)

University of Michigan Undergraduate Program, Ann Arbor, MI, USA.

Whitney Townsend (W)

Taubman Health Sciences Library, University of Michigan Library, Ann Arbor, MI, USA.

Heather Gladue (H)

Arthritis & Osteoporosis Consultants of the Carolinas, Charlotte, NC, USA.

David Badesch (D)

Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado, Denver, CO, USA.

J Simon R Gibbs (JSR)

National Heart and Lung Institute, Imperial College London, London, UK.

Deepa Gopalan (D)

Department of Radiology, Imperial College London, London, UK.

Alessandra Manes (A)

Department of Investigational, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

Ronald Oudiz (R)

LA Biomedical Research Institute at Harbor-University of California Los Angeles, Torrance, CA, USA.

Toru Satoh (T)

Division of Cardiology, Department of Medicine, Kyorin University School of Medicine, Tokyo, Japan.

Adam Torbicki (A)

Medical Centre for Postgraduate Education, CMKP European Health Centre, Otwock, Poland.

Fernando Torres (F)

University of Texas Southwestern Medical Center, Dallas, TX, USA.

Vallerie McLaughlin (V)

Division of Cardiology, University of Michigan, Ann Arbor, MI, USA.

Dinesh Khanna (D)

Division of Rheumatology, Scleroderma Program, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. Electronic address: khannad@med.umich.edu.

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