Pulmonary hypertension in systemic sclerosis: prevalence, incidence and predictive factors in a large multicentric Italian cohort

被引:0
作者
Iudici, M. [1 ]
Codullo, V. [2 ]
Giuggioli, D. [3 ,4 ]
Riccieri, V. [5 ]
Cuomo, G. [1 ]
Breda, S. [2 ]
Manfredi, A. [3 ,4 ]
Iannace, N. [5 ]
D'Alto, M. [6 ,7 ]
Ghio, S. [8 ]
Rossi, R. [4 ,9 ]
Vizza, C. D. [10 ]
Caporali, R. [2 ]
Valesini, G. [5 ]
Ferri, C. [3 ,4 ]
Valentini, G. [1 ]
机构
[1] Univ Naples 2, Unita Reumatol, I-80131 Naples, Italy
[2] Univ Pavia, Div Rheumatol, IRCCS Policlin San Matteo Fdn, I-27100 Pavia, Italy
[3] Univ Modena & Reggio Emilia, Rheumatol Unit, Modena, Italy
[4] Policlin Modena, Azienda Osped Univ, Modena, Italy
[5] Univ Roma La Sapienza, Rheumatol Unit, Dept Internal Med & Clin Special, I-00185 Rome, Italy
[6] Univ Naples 2, Dept Cardiol, I-80131 Naples, Italy
[7] Monaldi Hosp, Naples, Italy
[8] Fdn IRCCS Policlin S Matte, Dept Cardiol, Pavia, Italy
[9] Univ Modena & Reggio Emilia, Cardiol Unit, Modena, Italy
[10] Univ Roma La Sapienza, Dept Cardiovasc Sci, I-00185 Rome, Italy
关键词
pulmonary hypertension; systemic sclerosis; epidemiology; ARTERIAL-HYPERTENSION; DIFFUSING-CAPACITY; EPIDEMIOLOGY; SCLERODERMA; GENETICS; SURVIVAL; DISEASE; PROFILE; TRIALS;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. This paper aims to investigate the prevalence, the incidence of pulmonary hypertension (PH) and its subtypes in Italian patients with systemic sclerosis (SSc) and to characterise features associated with and predictive of development of PH. Methods. Eight-hundred and sixty-seven consecutive SSc patients recruited at 4 Italian centres were enrolled. At admission, all patients underwent a careful history, physical examination, EKG, lung high resolution computed tomography (HRCT), pulmonary function tests, B-mode echocardiography and right heart catheterisation (RHC), if indicated. Patients were then visited every 6-12 months. A RHC was performed in those patients in whom PH was suspected for the presence of pre-specified criteria. Results. Among the 212 patients in whom it was suspected, PH was confirmed by RHC in 69 patients. On 31st December 2010, the point prevalence of P-arterial-H(PAH) and PH associated with interstitial lung disease (PH-ILD) was 3.7% and 1.4%, respectively; that of postcapillary PH was 13%. The estimated incidence rates of PH and PAH were respectively 1.85/100 patient-years and 1.02/100 patient-years. Multivariate analysis indicated that diffusing lung capacity for CO (DLCO) <= 55% (HR 4.45, 95%CI 224-8.83; p<0.001) and sPAP >40 mmHg (HR 18.03, 95%CI 9.01-36.06; p<0.001) were associated with an increased risk to develop PAH. SystolicPAP >40 mmHg resulted the only predictor of PH-ILD (HR 5.17, 95%CI 1.37-19.5; p=0.018) and post-capillary PH (HR 7.91, 95%CI 1.88-33.1; p=0.005) development. Conclusion. Our study confirms a lower prevalence of PH in Italy compared to Anglo-Saxon cohorts. We also identified patients at high risk, who should be carefully monitored.
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收藏
页码:S31 / S36
页数:6
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