| Echocardiography, 6-minute walk distance, and distance-saturation product as predictors of pulmonary arterial hypertension in idiopathic pulmonary fibrosis. | |
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MedLine Citation:
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PMID: 20420729 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pulmonary arterial hypertension (PAH) is frequently seen in patients with idiopathic pulmonary fibrosis (IPF). We sought to examine the performance of echocardiography, 6-min walk test (6MWT) distance, distance-saturation product (DSP), and pulse oximetry (SpO2) in detecting underlying PAH in IPF. METHODS: 626 lung transplanted patients from February 1990 to December 2007 were considered. Subjects with pre-transplant diagnosis of IPF were evaluated. Based on findings in pre-transplant right heart catheterization, the presence or absence of PAH was recorded. Right-ventricle systolic pressure, 6MWT distance, DSP, and lowest SpO2 during 6MWT were compared in PAH and non-PAH groups. Receiver operating characteristic curves for each variable to assess prediction of PAH were constructed. RESULTS: 131 patients were transplanted due to IPF. Of these 131 patients, 58 (44%) were eligible. PAH was diagnosed by right heart catheterization in 25 (43%) of 58 eligible patients. The mean pulmonary arterial pressure in PAH patients was 33 mm Hg, and 19 mm Hg in non-PAH patients (P = .001). 6MWT distance was 321 m in the PAH group, and 346 m in the non-PAH one (P = .38). DSP in PAH subjects was 272 meters% and 286 meters% in those with no PAH (P = .57). The lowest SpO2 in the PAH and non-PAH groups were 84% and 82%, respectively (P = .38). The diagnostic accuracy of the echocardiography exceeded that of the other variables (area under the curve 0.72). CONCLUSIONS: Right-ventricle systolic pressure measured by echocardiography, by 6MWT distance, by DSP, or by SpO2 performs poorly in detecting PAH in IPF. Measured by right heart catheterization, right-ventricle systolic pressure performs better to predict PAH in IPF. |
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Authors:
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Ariel M Modrykamien; Ravindra Gudavalli; Kevin McCarthy; Joseph Parambil |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Respiratory care Volume: 55 ISSN: 0020-1324 ISO Abbreviation: Respir Care Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-27 Completed Date: 2010-07-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7510357 Medline TA: Respir Care Country: United States |
Other Details:
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Languages: eng Pagination: 584-8 Citation Subset: IM |
Affiliation:
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Respiratory Institute, A90, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. modryka@ccf.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Echocardiography
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methods* Exercise Test / methods* Female Heart Catheterization Humans Hypertension, Pulmonary / diagnosis*, etiology, physiopathology Idiopathic Pulmonary Fibrosis / complications*, physiopathology, surgery Lung Transplantation Male Middle Aged Oximetry Oxygen Consumption / physiology* Predictive Value of Tests Pulmonary Wedge Pressure ROC Curve Retrospective Studies Walking / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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