Predictive Value of Pulmonary Arterial Compliance in Systemic Lupus Erythematosus Patients With Pulmonary Arterial Hypertension
Pulmonary arterial hypertension is a serious complication of systemic lupus erythematosus. It is characterized by increased right ventricular afterload which mainly comprises pulmonary arterial compliance (PAC) and pulmonary vascular resistance. The role of PAC in predicting the outcome of systemic...
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| Veröffentlicht in: | Hypertension (Dallas, Tex. 1979) Tex. 1979), 2020-10, Vol.76 (4), p.1161-1168 |
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| container_title | Hypertension (Dallas, Tex. 1979) |
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| creator | Guo, Xiaoxiao Lai, Jinzhi Wang, Hui Tian, Zhuang Zhao, Jiuliang Li, Mengtao Fang, Quan Fang, Ligang Liu, Yongtai Zeng, Xiaofeng |
| description | Pulmonary arterial hypertension is a serious complication of systemic lupus erythematosus. It is characterized by increased right ventricular afterload which mainly comprises pulmonary arterial compliance (PAC) and pulmonary vascular resistance. The role of PAC in predicting the outcome of systemic lupus erythematosus-associated pulmonary arterial hypertension has not been investigated yet. Between February 2012 to December 2016, 120 consecutive patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension based on right heart catheterization were enrolled, prospectively. Baseline clinical characteristics and hemodynamic assessment were analyzed. Baseline right ventricular afterload was stratified according to the PAC and pulmonary vascular resistance. The end point was a composite of all-cause mortality and clinical worsening. Among them, end points occurred in 49 (41%) patients after 15 months (interquartile range, 8.5–24.0). Patients with a PAC |
| doi_str_mv | 10.1161/HYPERTENSIONAHA.120.15682 |
| format | Article |
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It is characterized by increased right ventricular afterload which mainly comprises pulmonary arterial compliance (PAC) and pulmonary vascular resistance. The role of PAC in predicting the outcome of systemic lupus erythematosus-associated pulmonary arterial hypertension has not been investigated yet. Between February 2012 to December 2016, 120 consecutive patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension based on right heart catheterization were enrolled, prospectively. Baseline clinical characteristics and hemodynamic assessment were analyzed. Baseline right ventricular afterload was stratified according to the PAC and pulmonary vascular resistance. The end point was a composite of all-cause mortality and clinical worsening. Among them, end points occurred in 49 (41%) patients after 15 months (interquartile range, 8.5–24.0). Patients with a PAC <1.39 mL/mm Hg had a 3.09-fold higher risk (95% CI, 1.54–6.20, P=0.001) of the end point events than the patients with a PAC ≥1.39 mL/mm Hg. Multivariable Cox regression analysis showed that stratified right ventricular afterload was the only independent predictor for the end point (hazard ratio, 2.009 [95% CI, 1.390–2.904], P<0.001). A 3-group prediction risk was created. The patients with the highest right ventricular afterload (PAC <1.39 mL/mm Hg and pulmonary vascular resistance ≥10.3Wood Unit) had the highest risk (χ2, 6.10; P<0.014) of experiencing the end point. Our results suggest that PAC is a good predictor of mortality and clinical worsening in systemic lupus erythematosus-associated pulmonary arterial hypertension. PAC, in addition to pulmonary vascular resistance, may be an attractive tool for screening high-risk populations in these patients.</description><identifier>ISSN: 0194-911X</identifier><identifier>EISSN: 1524-4563</identifier><identifier>DOI: 10.1161/HYPERTENSIONAHA.120.15682</identifier><identifier>PMID: 32772648</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Adult ; Cardiac Catheterization ; Female ; Heart Ventricles - physiopathology ; Hemodynamics - physiology ; Humans ; Lupus Erythematosus, Systemic - complications ; Lupus Erythematosus, Systemic - physiopathology ; Male ; Middle Aged ; Prognosis ; Pulmonary Arterial Hypertension - etiology ; Pulmonary Arterial Hypertension - physiopathology ; Pulmonary Artery - physiopathology ; Vascular Resistance - physiology ; Young Adult</subject><ispartof>Hypertension (Dallas, Tex. 1979), 2020-10, Vol.76 (4), p.1161-1168</ispartof><rights>American Heart Association, Inc</rights><rights>2020 American Heart Association, Inc</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4672-c3735e7887eb08ba67901e09e55d6646d4e040a78ad6b1eee01758e6543fbf93</citedby><cites>FETCH-LOGICAL-c4672-c3735e7887eb08ba67901e09e55d6646d4e040a78ad6b1eee01758e6543fbf93</cites><orcidid>0000-0003-4252-2889</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3685,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32772648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guo, Xiaoxiao</creatorcontrib><creatorcontrib>Lai, Jinzhi</creatorcontrib><creatorcontrib>Wang, Hui</creatorcontrib><creatorcontrib>Tian, Zhuang</creatorcontrib><creatorcontrib>Zhao, Jiuliang</creatorcontrib><creatorcontrib>Li, Mengtao</creatorcontrib><creatorcontrib>Fang, Quan</creatorcontrib><creatorcontrib>Fang, Ligang</creatorcontrib><creatorcontrib>Liu, Yongtai</creatorcontrib><creatorcontrib>Zeng, Xiaofeng</creatorcontrib><title>Predictive Value of Pulmonary Arterial Compliance in Systemic Lupus Erythematosus Patients With Pulmonary Arterial Hypertension</title><title>Hypertension (Dallas, Tex. 1979)</title><addtitle>Hypertension</addtitle><description>Pulmonary arterial hypertension is a serious complication of systemic lupus erythematosus. It is characterized by increased right ventricular afterload which mainly comprises pulmonary arterial compliance (PAC) and pulmonary vascular resistance. The role of PAC in predicting the outcome of systemic lupus erythematosus-associated pulmonary arterial hypertension has not been investigated yet. Between February 2012 to December 2016, 120 consecutive patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension based on right heart catheterization were enrolled, prospectively. Baseline clinical characteristics and hemodynamic assessment were analyzed. Baseline right ventricular afterload was stratified according to the PAC and pulmonary vascular resistance. The end point was a composite of all-cause mortality and clinical worsening. Among them, end points occurred in 49 (41%) patients after 15 months (interquartile range, 8.5–24.0). Patients with a PAC <1.39 mL/mm Hg had a 3.09-fold higher risk (95% CI, 1.54–6.20, P=0.001) of the end point events than the patients with a PAC ≥1.39 mL/mm Hg. Multivariable Cox regression analysis showed that stratified right ventricular afterload was the only independent predictor for the end point (hazard ratio, 2.009 [95% CI, 1.390–2.904], P<0.001). A 3-group prediction risk was created. The patients with the highest right ventricular afterload (PAC <1.39 mL/mm Hg and pulmonary vascular resistance ≥10.3Wood Unit) had the highest risk (χ2, 6.10; P<0.014) of experiencing the end point. Our results suggest that PAC is a good predictor of mortality and clinical worsening in systemic lupus erythematosus-associated pulmonary arterial hypertension. PAC, in addition to pulmonary vascular resistance, may be an attractive tool for screening high-risk populations in these patients.</description><subject>Adult</subject><subject>Cardiac Catheterization</subject><subject>Female</subject><subject>Heart Ventricles - physiopathology</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Lupus Erythematosus, Systemic - complications</subject><subject>Lupus Erythematosus, Systemic - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Pulmonary Arterial Hypertension - etiology</subject><subject>Pulmonary Arterial Hypertension - physiopathology</subject><subject>Pulmonary Artery - physiopathology</subject><subject>Vascular Resistance - physiology</subject><subject>Young Adult</subject><issn>0194-911X</issn><issn>1524-4563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE-P0zAQxS0EYsvCV0DmxiWL7Ti2c-BQVYWuVO1WbMWfk-UkE9XgxMF2WPXEV8dLFw4IIUayxiO_90b-IfSCkgtKBX21-bRbv9uvr24ur6-Wm-UFZfmhEoo9QAtaMV7wSpQP0YLQmhc1pR_P0JMYPxNCOefyMTormZRMcLVA33cBOtsm-w3we-NmwL7Hu9kNfjThiJchQbDG4ZUfJmfN2AK2I745xgSDbfF2nuaI1-GYDjCY5GOediZZGFPEH2w6_C1rc5wg38do_fgUPeqNi_Dsvp-j_Zv1frUpttdvL1fLbdFyIVnRlrKsQColoSGqMULWhAKpoao6IbjoOBBOjFSmEw0FAEJlpUBUvOybvi7P0ctT7BT81xli0oONLThnRvBz1IyXTAmREWZpfZK2wccYoNdTsEP-gKZE3-HXf-DXGb_-iT97n9-vmZsBut_OX7yz4PVJcOtdphG_uPkWgj6AcenwXwv4P_wkF2dCFYwwQu-mIh9alz8A-g-ovg</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Guo, Xiaoxiao</creator><creator>Lai, Jinzhi</creator><creator>Wang, Hui</creator><creator>Tian, Zhuang</creator><creator>Zhao, Jiuliang</creator><creator>Li, Mengtao</creator><creator>Fang, Quan</creator><creator>Fang, Ligang</creator><creator>Liu, Yongtai</creator><creator>Zeng, Xiaofeng</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4252-2889</orcidid></search><sort><creationdate>202010</creationdate><title>Predictive Value of Pulmonary Arterial Compliance in Systemic Lupus Erythematosus Patients With Pulmonary Arterial Hypertension</title><author>Guo, Xiaoxiao ; Lai, Jinzhi ; Wang, Hui ; Tian, Zhuang ; Zhao, Jiuliang ; Li, Mengtao ; Fang, Quan ; Fang, Ligang ; Liu, Yongtai ; Zeng, Xiaofeng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4672-c3735e7887eb08ba67901e09e55d6646d4e040a78ad6b1eee01758e6543fbf93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Cardiac Catheterization</topic><topic>Female</topic><topic>Heart Ventricles - physiopathology</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Lupus Erythematosus, Systemic - complications</topic><topic>Lupus Erythematosus, Systemic - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Pulmonary Arterial Hypertension - etiology</topic><topic>Pulmonary Arterial Hypertension - physiopathology</topic><topic>Pulmonary Artery - physiopathology</topic><topic>Vascular Resistance - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guo, Xiaoxiao</creatorcontrib><creatorcontrib>Lai, Jinzhi</creatorcontrib><creatorcontrib>Wang, Hui</creatorcontrib><creatorcontrib>Tian, Zhuang</creatorcontrib><creatorcontrib>Zhao, Jiuliang</creatorcontrib><creatorcontrib>Li, Mengtao</creatorcontrib><creatorcontrib>Fang, Quan</creatorcontrib><creatorcontrib>Fang, Ligang</creatorcontrib><creatorcontrib>Liu, Yongtai</creatorcontrib><creatorcontrib>Zeng, Xiaofeng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guo, Xiaoxiao</au><au>Lai, Jinzhi</au><au>Wang, Hui</au><au>Tian, Zhuang</au><au>Zhao, Jiuliang</au><au>Li, Mengtao</au><au>Fang, Quan</au><au>Fang, Ligang</au><au>Liu, Yongtai</au><au>Zeng, Xiaofeng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive Value of Pulmonary Arterial Compliance in Systemic Lupus Erythematosus Patients With Pulmonary Arterial Hypertension</atitle><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle><addtitle>Hypertension</addtitle><date>2020-10</date><risdate>2020</risdate><volume>76</volume><issue>4</issue><spage>1161</spage><epage>1168</epage><pages>1161-1168</pages><issn>0194-911X</issn><eissn>1524-4563</eissn><abstract>Pulmonary arterial hypertension is a serious complication of systemic lupus erythematosus. It is characterized by increased right ventricular afterload which mainly comprises pulmonary arterial compliance (PAC) and pulmonary vascular resistance. The role of PAC in predicting the outcome of systemic lupus erythematosus-associated pulmonary arterial hypertension has not been investigated yet. Between February 2012 to December 2016, 120 consecutive patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension based on right heart catheterization were enrolled, prospectively. Baseline clinical characteristics and hemodynamic assessment were analyzed. Baseline right ventricular afterload was stratified according to the PAC and pulmonary vascular resistance. The end point was a composite of all-cause mortality and clinical worsening. Among them, end points occurred in 49 (41%) patients after 15 months (interquartile range, 8.5–24.0). Patients with a PAC <1.39 mL/mm Hg had a 3.09-fold higher risk (95% CI, 1.54–6.20, P=0.001) of the end point events than the patients with a PAC ≥1.39 mL/mm Hg. Multivariable Cox regression analysis showed that stratified right ventricular afterload was the only independent predictor for the end point (hazard ratio, 2.009 [95% CI, 1.390–2.904], P<0.001). A 3-group prediction risk was created. The patients with the highest right ventricular afterload (PAC <1.39 mL/mm Hg and pulmonary vascular resistance ≥10.3Wood Unit) had the highest risk (χ2, 6.10; P<0.014) of experiencing the end point. Our results suggest that PAC is a good predictor of mortality and clinical worsening in systemic lupus erythematosus-associated pulmonary arterial hypertension. PAC, in addition to pulmonary vascular resistance, may be an attractive tool for screening high-risk populations in these patients.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>32772648</pmid><doi>10.1161/HYPERTENSIONAHA.120.15682</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4252-2889</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Cardiac Catheterization Female Heart Ventricles - physiopathology Hemodynamics - physiology Humans Lupus Erythematosus, Systemic - complications Lupus Erythematosus, Systemic - physiopathology Male Middle Aged Prognosis Pulmonary Arterial Hypertension - etiology Pulmonary Arterial Hypertension - physiopathology Pulmonary Artery - physiopathology Vascular Resistance - physiology Young Adult |
| title | Predictive Value of Pulmonary Arterial Compliance in Systemic Lupus Erythematosus Patients With Pulmonary Arterial Hypertension |
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