Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 ESC/ERS definition of pulmonary hypertension and impact on mortality

Autor: Sébastien Puigrenier, Jonathan Giovannelli, Nicolas Lamblin, Pascal De Groote, Marie Fertin, Jean-François Bervar, Antoine Lamer, Jean-Louis Edmé, Marie-Hélène Balquet, Vincent Sobanski, David Launay, Éric Hachulla, Sébastien Sanges
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Respiratory Research, Vol 23, Iss 1, Pp 1-13 (2022)
Druh dokumentu: article
ISSN: 1465-993X
DOI: 10.1186/s12931-022-02205-4
Popis: Abstract Background and objective The definition of pre-capillary pulmonary hypertension (PH) has been modified, with lowering of the mean pulmonary arterial pressure (mPAP) threshold from 25 to 20 mmHg and addition of a mandatory criterion of pulmonary vascular resistance (PVR) ≥ 2 Wood units (WU). Our objectives were: 1/ to estimate the proportion of patients reclassified as having pre-capillary PH when using the new 2022 ESC/ERS hemodynamic criteria (i.e. mPAP 21-24 mmHg and PVR ≥ 2 WU), and to describe their clinical characteristics and outcome; and 2/ to study the relationship between PVR and survival in patients with mPAP > 20 mmHg. Methods We retrospectively analyzed consecutive SSc patients included in our National Reference Center for a first right-heart catheterization between 2003 and 2018. The association between survival and PVR was studied using smoothing splines. Results We included 126 SSc patients with mPAP > 20 mmHg. Among them, 16 (13%) had a baseline mPAP value between 21 and 24 mmHg and PVR ≥ 2 mmHg and were reclassified as pre-capillary PH; 10 of which (62%) raised their mPAP ≥ 25 mmHg during follow-up. In patients with mPAP > 20 mmHg, we observed a linear relation between PVR and mortality for values 25 mmHg, with a possibly less severe disease.
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