DLco and echocardiographic parameters in identifying mild pulmonary hypertension in the EUSTAR cohort of systemic sclerosis patients.

TAPSE/sPAP diffusing capacity of the lungs for carbon monoxide pulmonary hypertension screening systemic sclerosis

Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
05 Jun 2024
Historique:
received: 31 01 2024
revised: 09 05 2024
accepted: 21 05 2024
medline: 8 6 2024
pubmed: 8 6 2024
entrez: 7 6 2024
Statut: aheadofprint

Résumé

The 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines define pulmonary hypertension (PH) as a resting mean pulmonary artery pressure (mPAP) > 20 mmHg at right heart catheterization (RHC). Previously, patients with a mPAP between 21 and 24 mmHg were classified in a "grey zone" of unclear clinical significance. What is the diagnostic performance of the main parameters used for PH screening in detecting systemic sclerosis (SSc) patients with mPAP 21-24 mmHg at RHC? SSc patients from the European Scleroderma Trials and Research (EUSTAR) database with available tricuspid annular plane systolic excursion (TAPSE), systolic PAP (sPAP) and mPAP data were included. Patients with mPAP 21-24 mmHg and patients with mPAP ≤ 20 mmHg were considered for the analysis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated. TAPSE/sPAP was lower in the group of SSc patients with mPAP 21-24 mmHg than in non-PH group [0.58 (0.46-0.72) mm/mmHg vs 0.69 (0.57-0.81) mm/mmHg, p < 0.01]. No difference was found in other parameters between the two groups. Diffusing capacity of the lungs for carbon monoxide (DL DL

Sections du résumé

BACKGROUND BACKGROUND
The 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines define pulmonary hypertension (PH) as a resting mean pulmonary artery pressure (mPAP) > 20 mmHg at right heart catheterization (RHC). Previously, patients with a mPAP between 21 and 24 mmHg were classified in a "grey zone" of unclear clinical significance.
RESEARCH QUESTION OBJECTIVE
What is the diagnostic performance of the main parameters used for PH screening in detecting systemic sclerosis (SSc) patients with mPAP 21-24 mmHg at RHC?
STUDY DESIGN AND METHODS METHODS
SSc patients from the European Scleroderma Trials and Research (EUSTAR) database with available tricuspid annular plane systolic excursion (TAPSE), systolic PAP (sPAP) and mPAP data were included. Patients with mPAP 21-24 mmHg and patients with mPAP ≤ 20 mmHg were considered for the analysis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated.
RESULTS RESULTS
TAPSE/sPAP was lower in the group of SSc patients with mPAP 21-24 mmHg than in non-PH group [0.58 (0.46-0.72) mm/mmHg vs 0.69 (0.57-0.81) mm/mmHg, p < 0.01]. No difference was found in other parameters between the two groups. Diffusing capacity of the lungs for carbon monoxide (DL
INTERPRETATION CONCLUSIONS
DL

Identifiants

pubmed: 38849072
pii: S0012-3692(24)00683-4
doi: 10.1016/j.chest.2024.05.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Oliver Distler (O)
Mike Becker (M)
Melissa De Decker (M)
Danilo Alunni Fegatelli (DA)
Elise Siegert (E)
Ivan Castellví (I)
Alberto Cauli (A)
Kamal Solanki (K)
Lorenzo Dagna (L)
Mickaël Martin (M)
Gianluca Moroncini (G)
Hadi Poormoghim (H)
Masataka Kuwana (M)
Patricia E Carreira (PE)
Paolo Airò (P)
Julia Spierings (J)
Yoshiya Tanaka (Y)
Enrico Selvi (E)
Tomas Soukup (T)

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Amalia Colalillo (A)

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Eric Hachulla (E)

Univ. Lille, Inserm, CHU Lille, Department of Internal Medicine and Clinical Immunology, Hôpital Claude Huriez, CERAINOM, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France.

Chiara Pellicano (C)

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Vanessa Smith (V)

Department of Internal Medicine, Ghent University, Ghent, Belgium; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium.

Christina Bergmann (C)

Department of Internal Medicine, University Hospital Erlangen, Erlangen, Germany.

Gabriela Riemekasten (G)

Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany.

Elisabetta Zanatta (E)

Rheumatology Unit, Padova University Hospital, Padova, Italy.

Jörg Henes (J)

Centre for Interdisciplinary Rheumatology, Auto-inflammatory Diseases and Internal Medicine, University Hospital Tübingen, Tübingen.

David Launay (D)

Univ. Lille, Inserm, CHU Lille, Department of Internal Medicine and Clinical Immunology, Hôpital Claude Huriez, CERAINOM, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France.

Antonella Marcoccia (A)

Centro di Riferimento Interdisciplinare, Interdipartimentale per la diagnosi precoce della Sclerodermia (CRIIS), Sandro Pertini Hospital, Rome, Italy.

Ana Maria Gheorghiu (AM)

Carol Davila University on Medicine and Pharmacy, Internal Medicine and Rheumatology Department, Cantacuzino Hospital, Bucharest, Romania.

Marie-Elise Truchetet (ME)

Department of Rheumatology, CHU de Bordeaux, Bordeaux, France.

Florenzo Iannone (F)

Rheumatology Unit, University of Bari, Bari, Italy.

Carmen Pilar Simeón Aznar (CP)

Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain.

Susana Oliveira (S)

Systemic Immunomediated Diseases Unit, Department of Medicine, Amadora, Portugal.

Madelon Vonk (M)

Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.

Francesco Del Galdo (F)

Leeds Raynaud's And Scleroderma Program, NIHR Biomedical Research Centre Leeds Institute Of Rheumatic And Musculoskeletal Medicine, University of Leeds, United Kingdom.

Edoardo Rosato (E)

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: edoardo.rosato@uniroma1.it.

Classifications MeSH