Document Detail

Carbon monoxide diffusing capacity and mortality in pulmonary arterial hypertension.
MedLine Citation:
PMID:  19783169     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Abnormal carbon monoxide diffusing capacity (DLCO) is a marker of pulmonary vascular disease and predicts the presence of pulmonary arterial hypertension (PAH) and poor prognosis in diseases such as systemic sclerosis and idiopathic pulmonary fibrosis. Little is known of its prognostic utility in World Health Organization (WHO) Group I PAH. METHODS: We performed a cohort study of 408 patients with WHO Group I PAH from 1982 to 2006, with data on demographics, comorbidities, medications, functional class, laboratory tests, exercise testing, and hemodynamics. DLCO was determined upon entry into the study. We divided the cohort into tertiles based on DLCO and compared differences between groups. We used a Cox proportional hazards analysis to determine the association of DLCO with mortality, after adjusting for age, connective tissue disease etiology, functional class, pulmonary function testing variables, serum creatinine, albumin, hemoglobin, lung parenchymal abnormalities on chest computed tomography, oxygen use, and hemodynamic variables. RESULTS: The lowest tertile of DLCO was independently associated with an increased risk of death (univariate hazard ratio [HR] = 2.7, 95% confidence interval [CI] 1.9 to 3.9, p < 0.0001; multivariate HR = 2.4, 95% CI 1.1 to 5.0, p = 0.025). On receiving operator characteristic (ROC) curve analysis, the c-statistic for the multivariate model without DLCO was 0.75, whereas the c-statistic for the multivariate model with DLCO was 0.78 (p = 0.003 by likelihood ratio test). Importantly, a multivariate model with hemodynamic variables alone (c-statistic = 0.61) was quite inferior to the multivariate model, which included DLCO. CONCLUSION: DLCO is an independent predictor of death in patients with WHO Group I PAH.
Sonal Chandra; Sanjiv J Shah; Thenappan Thenappan; Stephen L Archer; Stuart Rich; Mardi Gomberg-Maitland
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-09-26
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  29     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-7     Citation Subset:  IM    
Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois.
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MeSH Terms
Biological Markers
Carbon Monoxide / metabolism*
Hypertension, Pulmonary / diagnosis*,  mortality*
Middle Aged
Predictive Value of Tests
Pulmonary Diffusing Capacity*
Severity of Illness Index
Reg. No./Substance:
0/Biological Markers; 630-08-0/Carbon Monoxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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