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Reichenberger, F; Voswinckel, R; Schulz, R; Mensch, O; Ghofrani, HA; Olschewski, H; Seeger, W.
Noninvasive detection of early pulmonary vascular dysfunction in scleroderma
RESP MED. 2009; 103(11): 1713-1718.
Doi: 10.1016/j.rmed.2009.05.004
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- Co-Autor*innen der Med Uni Graz
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Olschewski Horst
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- Abstract:
- Background: Pulmonary arterial hypertension is a serious complication in scleroderma and early diagnosis is warranted. Patients and methods: 33 Scleroderma patients (mean age 54 [SD 11] years) with normal systolic pulmonary artery pressure (sPAP), right and left ventricular parameters at rest were enrolled in this study. They were investigated by echocardiography during physical. exercise and hypoxia. A hypertensive pulmonary vascular reaction was diagnosed when sPAP inappropriately increased during exercise compared to individual. exercise tolerance, or if sPAP was >40 mm Hg during hypoxia exposure, respectively. Results: In 17 patients there was a normal increase of sPAP at exercise of 34 [8] mm Hg (mean VO2 max 70 [17]% predicted), and 29 [5] mm Hg during hypoxia. Sixteen patients developed a hypertensive pulmonary vascular response with a sPAP of 47 [9] mm Hg during exercise (VO2-max 64 [15]% pred.), and 54 [7] mm Hg mm Hg during hypoxia, respectively. The sPAP/VO2 max ratio was higher in patients with a hypertensive response (0.76 [0.17] vs. 0.49 [0.12] p < 0.0001). There was no difference in scleroderma subtype, duration of disease, gender or age between groups. During a 3-year follow up one patient with a hypertensive response developed manifest pulmonary arterial hypertension. Conclusion: Non-invasive assessment of pulmonary circulation during physical, exercise and/or hypoxia enables screening for pulmonary vascular dysfunction in scleroderma. (C) 2009 Elsevier Ltd. All rights reserved.
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Anoxia - complications
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Disease Progression -
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Echocardiography, Doppler -
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Endothelium, Vascular - physiopathology
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Exercise Test -
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Female -
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Humans -
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Hypertension, Pulmonary - etiology
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Male -
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Middle Aged -
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Oxygen Consumption -
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Prognosis -
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Pulmonary Artery - physiopathology
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Respiratory Function Tests -
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Scleroderma, Systemic - complications
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Treatment Outcome -
- Find related publications in this database (Keywords)
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Pulmonary hypertension
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Echocardiography
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Scleroderma
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Exercise
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Hypoxia