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Pulmonary Arterial Hypertension in Patients with Sarcoidosis: The Pulsar Single Center Experience.
MedLine Citation:
PMID:  22826080     Owner:  NLM     Status:  Publisher    
Sarcoidosis is a systemic granulomatous disease with unknown etiology. Lungs and lymph nodes are commonly affected. Also, cases of pulmonary hypertension (PH) and pulmonary arterial hypertension (PAH) are described. However, the exact prevalence of PAH in patients with sarcoidosis is unclear. A 111 patients with proven sarcoidosis were recruited from January 2010 to October 2010. All patients were studied prospectively by transthoracic echocardiography (TTE) for the presence of PH. In assumed PH, a right heart catheterization (RHC) followed if there were no other reasons for PH. In 23 of the 111 patients (21%) PH was assumed in TTE. Three patients presented with severe mitral insufficiency III° and IV°, in eight patients PH was supposed to be caused by chronic heart failure or relevant diastolic dysfunction > II°, two patients declined undergoing RHC. Of the ten patients investigated with RHC, four showed a precapillary pulmonary arterial hypertension and in one patient a postcapillary hypertension was diagnosed. All four patients with precapillary PH had a radiologic stage III and IV. In three of the four patients a significantly reduced transfer factor for carbon monoxide (TLCO) <50% was found. All patients with precapillary PH had a chronic course of sarcoidosis lasting ≥13 years. This is the first study which prospectively investigated a large cohort of patients with sarcoidosis for the prevalence of PH and PAH. The prevalence of precapillary PH was found to be at least 3.6% (4/111) and therefore exceeds the prevalence of PAH in the normal population by far. A chronic and progressive lung involvement due to sarcoidosis seems to be the most evident risk factor for developing a sarcoidosis PH.
Stefan Pabst; Christoph Hammerstingl; Natalie Grau; Jens Kreuz; Christian Grohe; Uwe R Juergens; Georg Nickenig; Dirk Skowasch
Publication Detail:
Journal Detail:
Title:  Advances in experimental medicine and biology     Volume:  755     ISSN:  0065-2598     ISO Abbreviation:  -     Publication Date:  2013  
Date Detail:
Created Date:  2012-7-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0121103     Medline TA:  Adv Exp Med Biol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  299-305     Citation Subset:  -    
Medical Clinic II, Division of Pneumology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany,
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