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The three-year incidence of pulmonary arterial hypertension associated with systemic sclerosis in a multicenter nationwide longitudinal study in France
- Source :
- Arthritis & Rheumatism. 60:1831-1839
- Publication Year :
- 2009
- Publisher :
- Wiley, 2009.
-
Abstract
- Objective An algorithm for the detection of pulmonary arterial hypertension (PAH), based on the presence of dyspnea and the findings of Doppler echocardiographic evaluation of the velocity of tricuspid regurgitation (VTR) and right-sided heart catheterization (RHC), which was applied in a large multicenter systemic sclerosis (SSc) population, estimated the prevalence of PAH to be 7.85%. The aim of this observational study was to investigate the incidence of PAH and pulmonary hypertension (PH) during a 3-year followup of patients from the same cohort (the ItinerAIR-Sclerodermie Study). Methods Patients with SSc and without evidence of PAH underwent evaluation for dyspnea and VTR at study entry and during subsequent visits. Patients in whom PAH was suspected because of a VTR of 2.8–3.0 meters/second and unexplained dyspnea or a VTR of >3.0 meters/second underwent RHC to confirm the diagnosis. Results A total of 384 patients were followed up for a mean ± SD of 41.03 ± 5.66 months (median 40.92 months). At baseline, 86.7% of the patients were women, and the mean ± SD age of the patients was 53.1 ± 12.0 years. The mean ± SD duration of SSc at study entry was 8.7 ± 7.6 years. After RHC, PAH was diagnosed in 8 patients, postcapillary PH in 8 patients, and PH associated with severe pulmonary fibrosis in 2 patients. The incidence of PAH was estimated to be 0.61 cases per 100 patient-years. Two patients who exhibited a mean pulmonary artery pressure of 20–25 mm Hg at baseline subsequently developed PAH. Conclusion The estimated incidence of PAH among patients with SSc was 0.61 cases per 100 patient-years. The high incidence of postcapillary PH highlights the value of RHC in investigating suspected PAH.
- Subjects :
- Adult
Male
Cardiac Catheterization
medicine.medical_specialty
Hypertension, Pulmonary
medicine.medical_treatment
Immunology
Population
Blood Pressure
Pulmonary Artery
030204 cardiovascular system & hematology
Doppler echocardiography
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Rheumatology
Internal medicine
medicine.artery
medicine
Humans
Immunology and Allergy
Pharmacology (medical)
Longitudinal Studies
education
Aged
Cardiac catheterization
030203 arthritis & rheumatology
education.field_of_study
Scleroderma, Systemic
medicine.diagnostic_test
business.industry
Incidence
Incidence (epidemiology)
Middle Aged
medicine.disease
Pulmonary hypertension
Echocardiography, Doppler
Tricuspid Valve Insufficiency
3. Good health
Surgery
Dyspnea
Blood pressure
Heart catheterization
Pulmonary artery
Cardiology
Female
France
business
Subjects
Details
- ISSN :
- 15290131 and 00043591
- Volume :
- 60
- Database :
- OpenAIRE
- Journal :
- Arthritis & Rheumatism
- Accession number :
- edsair.doi.dedup.....59d61c27c286a8ebc916fcf36d3e95aa