Document Detail


Pulmonary hypertension in patients with idiopathic pulmonary fibrosis.
MedLine Citation:
PMID:  16236900     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: To determine the impact on survival and clinical correlates of pulmonary hypertension (PH) occurring in patients with idiopathic pulmonary fibrosis (IPF). DESIGN: Retrospective study. SETTING: Tertiary care, referral medical center. PATIENTS: Among 487 consecutive patients with IPF, we identified 136 patients who underwent transthoracic echocardiography within 3 months of their initial evaluation at our institution. Patients with left ventricular dysfunction, valvular heart disease, incomplete follow-up, and those in whom pulmonary artery pressures could not be assessed were excluded; the remaining 88 patients were included in this study. Correlations were performed between echocardiographic measures of PH and clinical variables including survival. MEASUREMENTS AND RESULTS: The mean (+/- SD) estimated systolic pulmonary artery pressure (SPAP) for the 88 patients was 48 +/- 16 mm Hg (range, 28 to 116 mm Hg). Among pulmonary function parameters, SPAP correlated best with diffusing capacity of the lung for carbon monoxide (D(LCO)), to which it was inversely related. For survival analysis, patients were stratified into three groups: < or = 35 mm Hg (14 patients), 36 to 50 mm Hg (47 patients), and > 50 mm Hg (27 patients). Using the Kaplan-Meier method, the median survival rates for these three groups were 4.8 years, 4.1 years, and 0.7 years, respectively. Those patients with SPAP > 50 mm Hg had significantly worse survival compared to other subgroups (p = 0.009). CONCLUSION: In patients with IPF, PH correlates inversely with D(LCO) and has a significant adverse impact on survival, particularly when SPAP is > 50 mm Hg.
Authors:
Hassan F Nadrous; Patricia A Pellikka; Michael J Krowka; Karen L Swanson; Nithima Chaowalit; Paul A Decker; Jay H Ryu
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  128     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-20     Completed Date:  2005-11-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2393-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Pulmonary, Critical Care, and Internal Medicine, Mayo Clinic and Mayo Clinic College, 200 First St SW, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Echocardiography, Transesophageal
Female
Heart / physiopathology
Humans
Hypertension, Pulmonary / epidemiology,  etiology*,  mortality
Male
Middle Aged
Oxygen / blood
Oxygen Consumption
Pulmonary Fibrosis / complications*,  mortality,  ultrasonography
Survival Analysis
Vital Capacity
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Chest. 2005 Oct;128(4):1897-8   [PMID:  16236830 ]

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


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