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Frequency of Pleural Effusions in Patients with Pulmonary Arterial Hypertension Associated with Connective Tissue Diseases.
MedLine Citation:
PMID:  21212140     Owner:  NLM     Status:  Publisher    
Abstract BACKGROUND: Pleural effusions frequently accumulate in patients with left heart failure. However, our recent study in idiopathic and heritable pulmonary arterial hypertension (PAH) patients demonstrated that pleural effusions frequently occur in patients with isolated right heart failure (RHF). OBJECTIVES: To determine the frequency of pleural effusions in patients with PAH associated with connective tissue disease (CTD). METHODS: We retrospectively studied consecutive patients with PAH associated with CTD who were treated in the Vanderbilt Pulmonary Vascular Center. Pleural effusions were identified by chest radiograph, chest computed tomography scan, thoracic ultrasound, or autopsy. RESULTS: Thirty-five of 89 patients (39.3%) with PAH associated with CTD had pleural effusions: 23/51 (45.1%) with scleroderma, 6/16 (37.5%) with systemic lupus erythematosus (SLE), 5/18 (27.8%) with mixed connective tissue disease (MCTD) and 1/2 (50.0%) with Sjogren's syndrome. There were alternative explanations for the pleural effusions in six of these patients. Of the 29 patients without alternative explanation for their pleural effusions, 28 had RHF. When compared to the patients without pleural effusions, the 29 patients with pleural effusions had significantly higher mean right atrial pressures (11.3 ± 5.1 mmHg vs 8.3 ± 4.0 mmHg, p = 0.004) and lower cardiac indices (2.1 ± 0.6 L.min(-1).m(-2) vs 2.5 ± 0.7 L.min(-1).m(-2), p = 0.011). The pleural effusions were predominantly trace to small (58.6%) in size and bilateral (51.7%) in distribution. CONCLUSIONS: Pleural effusions frequently accumulate in patients with PAH associated with CTD, and are associated with RHF.
Yi-Feng Luo; Ivan M Robbins; Mevlut Karatas; Anupama G Brixey; Todd W Rice; Richard W Light
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-6
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
aDepartment of Pulmonary Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
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