肺动脉高压 - The Left Main and Coronary Artery Bifurcation Lesion Summit (CBS)

Abstract

Prognostic Effect and Longitudinal Hemodynamic Assessment of Borderline Pulmonary Hypertension
Skeletal muscle mitochondrial oxidative phosphorylation function in idiopathic pulmonary arterial hypertension: in vivo and in vitro study
2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT)
Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study
The association between body mass index and obesity with survival in pulmonary arterial hypertension
Impact of age and comorbidity on risk stratification in idiopathic pulmonary arterial hypertension
Clinical and genetic characteristics of pulmonary arterial hypertension in Lebanon
Right ventricular stroke work correlates with outcomes in pediatric pulmonary arterial hypertension
Sildenafil for improving outcomes in patients with corrected valvular heart disease and persistent pulmonary hypertension: a multicenter, double-blind, randomized clinical trial
中国肺高血压诊断和治疗指南2018

|<< 1 2 3 4 5 6 7 8 >>|

Original Research

2014 Jul;73(7):1340-9.

JOURNAL：Ann Rheum Dis.

Article Link

Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study

Coghlan JG, Denton CP, DETECT study group.

9023

Keywords: Arterial Hypertension; Epidemiology; Systemic Sclerosis

ABSTRACT

OBJECTIVE - Earlier detection of pulmonary arterial hypertension (PAH), a leading cause of death in systemic sclerosis (SSc), facilitates earlier treatment. The objective of this study was to develop the first evidence-based detection algorithm for PAH in SSc.

METHODS - In this cross-sectional, international study conducted in 62 experienced centres from North America, Europe and Asia, adults with SSc at increased risk of PAH (SSc for >3 years and predicted pulmonary diffusing capacity for carbon monoxide <60%) underwent a broad panel of non-invasive assessments followed by diagnostic right heart catheterisation (RHC). Univariable and multivariable analyses selected the best discriminatory variables for identifying PAH. After assessment for clinical plausibility and feasibility, these were incorporated into a two-step, internally validated detection algorithm. Nomograms for clinical practice use were developed.

RESULTS - Of 466 SSc patients at increased risk of PAH, 87 (19%) had RHC-confirmed PAH. PAH was mild (64% in WHO functional class I/II). Six simple assessments in Step 1 of the algorithm determined referral to echocardiography. In Step 2, the Step 1 prediction score and two echocardiographic variables determined referral to RHC. The DETECT algorithm recommended RHC in 62% of patients (referral rate) and missed 4% of PAH patients (false negatives). By comparison, applying European Society of Cardiology/European Respiratory Society guidelines to these patients, 29% of diagnoses were missed while requiring an RHC referral rate of 40%.

CONCLUSIONS - The novel, evidence-based DETECT algorithm for PAH detection in SSc is a sensitive, non-invasive tool which minimises missed diagnoses, identifies milder disease and addresses resource usage.