Search our Database of Scientific Publications and Authors

I’m looking for a

    Details and Download Full Text PDF:
    Changes in pulmonary exercise haemodynamics in scleroderma: a 4-year prospective study.

    Eur Respir J 2017 Jul 13;50(1). Epub 2017 Jul 13.
    Dept of Internal Medicine, Division of Pulmonology, Medical University of Graz, Graz, Austria.
    Pulmonary arterial hypertension (PAH) is a feared complication of systemic sclerosis. In this prospective cohort study, we monitored the changes in resting and exercise pulmonary haemodynamics of scleroderma patients without initial PAH over a mean follow-up period of ∼4 years.All patients underwent exercise echocardiography and cardiopulmonary exercise testing at baseline and follow-up. A subgroup underwent exercise right heart catheter (RHC) investigations. The primary end-point was the echocardiographic systolic pulmonary arterial pressure at 50 W exercise (sPAP).We included 99 patients, of whom 58 had a complete dataset. Three out of 99 patients developed RHC-confirmed PAH (0.75 cases per 100 patient-years). sPAP increased (p<0.001) and peak oxygen uptake (secondary end-point) decreased significantly (p=0.001) during follow-up, but there was no significant change in resting sPAP (p=0.38). In the RHC subgroup (n=28), mean (m)PAP and pulmonary vascular resistance at 50 W increased significantly (p=0.02 and p=0.002, respectively), but resting mPAP was unchanged.Scleroderma patients without PAH develop a mild but significant deterioration of pulmonary exercise haemodynamics and exercise capacity over a 4-year follow-up period, indicating a progression of pulmonary vascular disease. The manifestation rate of RHC-confirmed PAH was 0.75 cases per 100 patient-years.
    PDF Download - Full Text Link
    ( Please be advised that this article is hosted on an external website not affiliated with
    Source Status ListingPossible

    Similar Publications

    Usefulness of echocardiography in the identification of an excessive increase in pulmonary arterial pressure in patients with systemic sclerosis.
    Kardiol Pol 2011 ;69(1):9-15
    Department of Internal Medicine and Cardiology, Medical University, Warsaw, Poland.
    Background: In systemic sclerosis (SSc), changes in the lungs and pulmonary hypertension (PH) are complications most adversely affecting the prognosis. Given the availability of specific treatment, early diagnosis of PH is very important. Exercise echocardiography, by increasing the patient's cardiac output, makes it possible to identify patients with elevated pulmonary artery pressure (PAP) during exercise. Read More
    Baseline characteristics and follow-up in patients with normal haemodynamics versus borderline mean pulmonary arterial pressure in systemic sclerosis: results from the PHAROS registry.
    Ann Rheum Dis 2012 Aug 2;71(8):1335-42. Epub 2012 Feb 2.
    Department of Internal Medicine, University of California, Los Angeles, California, USA.
    Background: Patients with normal (mean pulmonary arterial pressure (mPAP) ≤20 mm Hg) and borderline mean pulmonary pressures (21-24 mm Hg) are "at risk" of developing pulmonary hypertension (PH). The objectives of this analysis were to examine the baseline characteristics in systemic sclerosis (SSc) with normal and borderline mPAP and to explore long-term outcomes in SSc patients with borderline mPAP versus normal haemodynamics.

    Methods: PHAROS is a multicentre prospective longitudinal cohort of patients with SSc "at risk" or recently diagnosed with resting PH on right heart catheterisation (RHC). Read More
    Exercise pulmonary haemodynamics predict outcome in patients with systemic sclerosis.
    Eur Respir J 2016 12 6;48(6):1658-1667. Epub 2016 Oct 6.
    Dept of Pulmonology, University Hospital Zurich and Center for Integrative Human Physiology, University of Zurich, Switzerland
    The aim of the present study was to investigate the prognostic value of exercise haemodynamics measured during right heart catheterisation (RHC) in patients with systemic sclerosis (SSc) referred for evaluation of pulmonary hypertension.SSc patients undergoing RHC at rest and during maximal supine incremental cycle exercise were grouped into resting precapillary pulmonary hypertension (PH) (mean pulmonary artery pressure (mPAP) ≥25 mmHg, pulmonary artery wedge pressure <15 mmHg), exercise-induced pulmonary hypertension (PH) (mPAP ≥30 mmHg and mPAP/cardiac output >3 mmHg·L·min at maximal exercise), and without pulmonary hypertension (PH). Patients' characteristics, haemodynamics and follow up data were compared between groups. Read More
    Cardiopulmonary exercise testing for detecting pulmonary arterial hypertension in systemic sclerosis.
    Heart 2017 05 6;103(10):774-782. Epub 2017 Jan 6.
    Herzzentrum der Universität zu Köln, Klinik III für Innere Medizin, Cologne, Germany.
    Objectives: Pulmonary arterial hypertension (PAH) is a devastating disease with limited survival and occurs as a frequent complication in patients with systemic sclerosis (SSc). A definite diagnosis of PAH is obtained by right heart catheterisation (RHC); however, the initial suspicion is raised by non-invasive methods. We assessed the diagnostic accuracy of key parameters derived from cardiopulmonary exercise testing (CPET) for detecting and ruling out SSc-associated PAH. Read More