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Determinants of impairment in lung diffusing capacity in patients with systemic sclerosis.
Determinants of impairment in lung diffusing capacity in patients with systemic sclerosis.
- Source :
-
Clinical and experimental rheumatology [Clin Exp Rheumatol] 2015 Jul-Aug; Vol. 33 (4 Suppl 91), pp. S80-6. Date of Electronic Publication: 2015 Apr 16. - Publication Year :
- 2015
-
Abstract
- Objectives: Lung diffusing capacity for carbon monoxide (DLCO) is impaired in interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) associated to systemic sclerosis (SSc), but the mechanism of DLCO reduction remains controversial. We hypothesised that the determinants of DLCO impairment differ in interstitial or vascular involvement of the lung of SSc patients.<br />Methods: DLCO was partitioned into alveolar-capillary membrane conductance (Dm) and pulmonary capillary blood volume (Vc) using combined single-breath DLNO and DLCO measurements. Seventeen SSc patients without pulmonary involvement (SSc), 20 SSc patients with ILD (SSc-ILD), with and without PAH, and 21 healthy controls were included.<br />Results: DLNO and Dm were reduced in SSc patients as compared with controls, whereas Vc was not significantly different. SSc-ILD patients showed a highly significant decrease in Dm and Vc as compared with SSc patients and controls. Vc tended to be more reduced than Dm in SSc-ILD patients with PAH. Dm and Vc were negatively correlated with PAPs and HCRT scores, but the relationship with the HRCT score was stronger.<br />Conclusions: DLNO is more sensitive than DLCO in detecting functional impairment in SSc without radiologic or haemodynamic alterations. A disproportional reduction of Dm relative to Vc suggests a thickening of the blood-gas diffusion barrier in these patients. In SSc patients with detectable ILD, the gas exchange impairment is due to both components of lung diffusing capacity, and partitioning of DLCO in Dm and Vc is of little use in distinguishing the patients with only ILD from those with ILD complicated by PAH.
- Subjects :
- Adult
Biomarkers blood
Blood-Aqueous Barrier metabolism
Blood-Aqueous Barrier pathology
Breath Tests
Capillary Permeability
Carbon Monoxide blood
Case-Control Studies
Female
Hemodynamics
Humans
Hypertension, Pulmonary blood
Hypertension, Pulmonary diagnosis
Hypertension, Pulmonary physiopathology
Lung Diseases, Interstitial blood
Lung Diseases, Interstitial diagnosis
Lung Diseases, Interstitial physiopathology
Male
Middle Aged
Nitric Oxide blood
Predictive Value of Tests
Scleroderma, Systemic diagnosis
Spirometry
Hypertension, Pulmonary etiology
Lung physiopathology
Lung Diseases, Interstitial etiology
Pulmonary Diffusing Capacity
Scleroderma, Systemic complications
Subjects
Details
- Language :
- English
- ISSN :
- 0392-856X
- Volume :
- 33
- Issue :
- 4 Suppl 91
- Database :
- MEDLINE
- Journal :
- Clinical and experimental rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 25897784