Pulmonary arterial hypertension and systemic sclerosis relation: a single centre experience

Heart Lung Circ. 2014 Jul;23(7):667-73. doi: 10.1016/j.hlc.2014.02.002. Epub 2014 Feb 14.

Abstract

Aim: In systemic sclerosis (SSc), this single-centre study aimed to define the frequency and association of pulmonary arterial hypertension (PAH), occurring either alone in SSc-PAH or together with interstitial lung disease (ILD-PH).

Material-methods: SSc cases between the years 1990-2011 were reviewed, retrospectively. Patients' clinical, laboratory findings, Modified Rodnan Skin Score and Medsger score, 6-minute walk distance (6MWD), carbon monoxide diffusion test (DLCO), echocardiography, thorax HRCT, and right heart catheterisation findings were recorded.

Results: One hundred and forty-one cases (F/M:124/17, diffuse cutaneous SSc (DcSSc)/limited cutaneous SSc (LcSSc): 84/57) were included in the study with the mean age of 52.70±15.17 years and disease duration of 107.07±99.44 months. PaO₂, FEV1 and FVC were lower in DcSSc (p<0.05) as compared to LcSSc, but DLCO and 6MWD did not differ significantly, between the two forms. Ground glass opacity (64.7%) and interlobular septal thickening (58.8%) were the most frequent findings on HRCT of such subjects. PAH was detected in 34 subjects (24.1%). Seven of them had SSc associated PAH (SSc-PAH) and 27 ILD-PH. Both frequencies were similar between DcSSc and LcSSc. Mean sPAP was higher in SSc-PAH.

Conclusion: PAH was observed in approximately one fourth of patients; therefore advanced cardio-pulmonary investigation should be routinely performed in the SSc patients' management.

Keywords: Diffuse cutaneous scleroderma; Interstitial lung disease; Limited cutaneous scleroderma; Pulmonary arterial hypertension; Systemic sclerosis.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hypertension, Pulmonary / epidemiology*
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / pathology
  • Hypertension, Pulmonary / physiopathology
  • Hypertension, Pulmonary / therapy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / epidemiology*
  • Scleroderma, Systemic / pathology
  • Scleroderma, Systemic / physiopathology
  • Scleroderma, Systemic / therapy