Gregorio Miguel Pérez-Peñate1, Iñigo Rúa-Figueroa2, Gabriel Juliá-Serdá2, Fernándo León-Marrero2, Antonio García-Quintana2, José Ramón Ortega-Trujillo2, Celia Erausquin-Arruabarrena2, Carlos Rodríguez-Lozano2, Pedro Cabrera-Navarro2, Nazario Ojeda-Betancor2, Miguel Ángel Gómez-Sánchez2. 1. From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre. gperpen@gobiernodecanarias.org. 2. From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
Abstract
OBJECTIVE: Pulmonary arterial hypertension (PAH) prevalence has been reported to be between 0.5% and 17% in systemic lupus erythematosus (SLE). This study assessed PAH prevalence and predictors in an SLE cohort. METHODS: The Borg dyspnea scale, DLCO, N-terminal pro-brain natriuretic peptide (NT-proBNP), and Doppler echocardiographic (DE) were performed. An echocardiographic Doppler exercise test was conducted in selected patients. When DE systolic pulmonary arterial pressure was ≥ 45 mmHg or increased during exercise > 20 mmHg, a right heart catheterization was performed. Hemodynamic during exercise was measured if rest mean pulmonary arterial pressure was < 25 mmHg. RESULTS: Of the 203 patients with SLE, 152 were included. The mean age was 44.9 ± 12.3 years, and 94% were women. Three patients had known PAH. The algorithm diagnosed 1 patient with chronic thromboembolic pulmonary hypertension and 5 with exercise-induced pulmonary artery pressure increase (4 with occult left diastolic dysfunction). These patients had significantly more dyspnea, higher NT-proBNP, and lower DLCO. CONCLUSION: These data confirm the low prevalence of PAH in SLE. In our cohort, occult left ventricular diastolic dysfunction was a frequent diagnosis of unexplained dyspnea. Dyspnea, DLCO, and NT-proBNP could be predictors of pulmonary hypertension in patients with SLE.
OBJECTIVE:Pulmonary arterial hypertension (PAH) prevalence has been reported to be between 0.5% and 17% in systemic lupus erythematosus (SLE). This study assessed PAH prevalence and predictors in an SLE cohort. METHODS: The Borg dyspnea scale, DLCO, N-terminal pro-brain natriuretic peptide (NT-proBNP), and Doppler echocardiographic (DE) were performed. An echocardiographic Doppler exercise test was conducted in selected patients. When DE systolic pulmonary arterial pressure was ≥ 45 mmHg or increased during exercise > 20 mmHg, a right heart catheterization was performed. Hemodynamic during exercise was measured if rest mean pulmonary arterial pressure was < 25 mmHg. RESULTS: Of the 203 patients with SLE, 152 were included. The mean age was 44.9 ± 12.3 years, and 94% were women. Three patients had known PAH. The algorithm diagnosed 1 patient with chronic thromboembolic pulmonary hypertension and 5 with exercise-induced pulmonary artery pressure increase (4 with occult left diastolic dysfunction). These patients had significantly more dyspnea, higher NT-proBNP, and lower DLCO. CONCLUSION: These data confirm the low prevalence of PAH in SLE. In our cohort, occult left ventricular diastolic dysfunction was a frequent diagnosis of unexplained dyspnea. Dyspnea, DLCO, and NT-proBNP could be predictors of pulmonary hypertension in patients with SLE.
Authors: Pedro Anuardo; Monica Verdier; Natali W S Gormezano; Gabriela R V Ferreira; Gabriela N Leal; Alessandro Lianza; Juliana C O A Ferreira; Rosa M R Pereira; Nadia E Aikawa; Maria Teresa Terreri; Claudia S Magalhães; Simone Appenzeller; Maria Carolina Dos Santos; Silvana B Sachetti; Claudio A Len; Gecilmara S Pilleggi; Simone Lotufo; Eloisa Bonfá; Clovis A Silva Journal: Pediatr Cardiol Date: 2016-11-08 Impact factor: 1.655