Document Detail

Echocardiography, 6-minute walk distance, and distance-saturation product as predictors of pulmonary arterial hypertension in idiopathic pulmonary fibrosis.
MedLine Citation:
PMID:  20420729     Owner:  NLM     Status:  MEDLINE    
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.
Ariel M Modrykamien; Ravindra Gudavalli; Kevin McCarthy; Joseph Parambil
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Respiratory care     Volume:  55     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-07-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  584-8     Citation Subset:  IM    
Respiratory Institute, A90, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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MeSH Terms
Echocardiography / methods*
Exercise Test / methods*
Heart Catheterization
Hypertension, Pulmonary / diagnosis*,  etiology,  physiopathology
Idiopathic Pulmonary Fibrosis / complications*,  physiopathology,  surgery
Lung Transplantation
Middle Aged
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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