Document Detail


Prevalence of exercise pulmonary arterial hypertension in scleroderma.
MedLine Citation:
PMID:  18634147     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pulmonary arterial hypertension (PAH) is a complication of scleroderma (systemic sclerosis, SSc); as soon as PAH develops, the patient's prognosis deteriorates rapidly. Early detection of PAH ensures timely treatment. We investigated the prevalence of exercise-induced PAH in a cohort of patients with SSc, and examined the relation between exercise-induced PAH and clinical characteristics and biochemical markers. METHODS: Patients with SSc and normal resting systolic pulmonary arterial pressure (sPAP) were studied. Eligible patients were asked to perform cycloergometer exercise until exhaustion, and exercise sPAP was measured. All patients had their pulmonary function tested and underwent echocardiography at rest. Brain natriuretic peptide (BNP) was also determined. RESULTS: Forty-one patients with SSc were studied. Mean sPAP at rest was 29.7 mm Hg, rising to a mean of 41.4 mm Hg on exercise. Eleven of 41 patients (26.8%) had sPAP post-exercise > 50 mm Hg and 8/41 (19.5%) > 55 mm Hg. A significant correlation was found between exercise sPAP and DLCO (p = 0.008) and between sPAP and BNP levels (p = 0.04). Pre-existing severe Raynaud's phenomenon was more prevalent (50% vs 20%), DLCO levels lower (78.9 vs 92.7 % predicted), and BNP levels higher (72.6 vs 42.1 pmol/ml) in patients with exercise sPAP > 55 mm Hg. CONCLUSION: The prevalence of exercise-induced PAH in patients with scleroderma is high. Patients with lower DLCO and higher levels of BNP are at higher risk of developing higher sPAP. Studies with longterm followup are required to evaluate the risk of developing resting PAH in these patients.
Authors:
Jose Luis Callejas-Rubio; Eduardo Moreno-Escobar; Pilar Martín de la Fuente; Lourdes López Pérez; Raquel Rios Fernández; Daniel Sánchez-Cano; José Pomares Mora; Norberto Ortego-Centeno
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  35     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-11     Completed Date:  2008-12-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1812-6     Citation Subset:  IM    
Affiliation:
Unidad de Enfermedades Autoinmunes Sistémicas, Granada, Spain. JLCALLEJA@telefonica.net
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure Determination
Cross-Sectional Studies
Disease Progression
Echocardiography, Doppler
Exercise*
Exercise Test
Exercise Tolerance*
Female
Humans
Hypertension, Pulmonary / blood,  etiology*,  physiopathology
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Prevalence
Respiratory Function Tests
Scleroderma, Systemic / blood,  complications*,  physiopathology
Spain
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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


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