Prevalence of pulmonary hypertension in limited and diffuse scleroderma
Abstract
Study objectives To characterize the prevalence of undiagnosed pulmonary hypertension in patients with limited and diffuse scleroderma.Design Prospective cross-sectional study.Setting University-based outpatient clinic.Patients Thirty-four consecutive patients with limited (n = 29) or diffuse (n = 5) scleroderma but without the clinical diagnosis of pulmonary hypertension.Measurements and results All patients had 12-lead ECGs and two-dimensional and Doppler echocardiograms. The pulmonary artery systolic pressure (PAs) was calculated as the sum of the Doppler transtricuspid pressure gradient and the right atrial pressure as estimated by the caval respiratory index. Thirty-three patients (97%) had adequate spectral signals of tricuspid regurgitation. The velocity of tricuspid regurgitation ranged from 1.6 to 4.5 m/s. The calculated PAs ranged from 15 to 95 (mean +/- SD = 30 +/- 14 mm Hg). Twelve patients (35% of the total cohort) had pulmonary hypertension defined as PAs of 30 mm Hg or greater.Conclusions Undiagnosed elevation of PAs is common in patients with scleroderma. Noninvasive assessment of PAs can be performed accurately in most patients independent of clinical signs of pulmonary hypertension. If successful treatment strategies are identified, it may be possible to identify patients early in the development of pulmonary hypertension and intervene before significant end-organ damage occurs.
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Several diseases that share both disproportionately high rates of vascular disease and PH, including Sjögren's and systemic sclerosis, HIV, and cystic fibrosis, also feature dysregulated salivary flow and altered oral microbial populations.
“Significantly, several diseases that share both disproportionately high rates of vascular disease and PH, including Sjögren's and systemic sclerosis[294–297], HIV[7,11], and cystic fibrosis[298] also feature dysregulated salivary flow[299–302] and altered oral microbial populations[224,303–306].”
From Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health (2017) · cites this paper as [294]
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- Authors
- Battle, R. W., Davitt, M. A., Cooper, S. M., Buckley, L. M., Leib, E. S., Beglin, P. A., & Tischler, M. D.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Tischler, Marc D.
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 1996-12
- Volume
- 110
- Issue
- 6
- Pages
- 1515-1519
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2044254366
- Cited by
- 158
- References
- 23
- Citations by year
- 2023: 1 · 2022: 6 · 2021: 4 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 4
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Keywords
- pulmonary hypertension, systemic sclerosis, limited cutaneous systemic sclerosis, diffuse cutaneous systemic sclerosis, prevalence, tricuspid regurgitation, pulmonary artery systolic pressure, Doppler echocardiography, non-invasive assessment, right atrial pressure
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Pressure, Cross-Sectional Studies, Electrocardiography, Female, Humans, Hypertension, Pulmonary, Male, Middle Aged, Prospective Studies, Pulmonary Artery, Pulmonary Diffusing Capacity, Pulmonary Ventilation, Scleroderma, Systemic, Tricuspid Valve Insufficiency, Echocardiography, Doppler
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