Academic Journal
The spectrum of systemic sclerosis-associated pulmonary hypertension: Insights from the ASPIRE registry
| العنوان: | The spectrum of systemic sclerosis-associated pulmonary hypertension: Insights from the ASPIRE registry |
|---|---|
| المؤلفون: | Smith, H., Thompson, A.A.R., Akil, M., Alabed, S., Charalampopoulos, A., Dwivedi, K., Elliot, C.A., Hameed, A., Haque, A., Hamilton, N., Hill, C., Hurdman, J., Kilding, R., Kuet, K.-P., Rajaram, S., Rothman, A.M.K., Swift, A.J., Wild, J.M., Kiely, D.G., Condliffe, R. |
| بيانات النشر: | Elsevier BV |
| سنة النشر: | 2024 |
| المجموعة: | White Rose Research Online (Universities of Leeds, Sheffield & York) |
| الوصف: | Background There are limited data assessing the spectrum of systemic sclerosis-associated pulmonary hypertension (PH). Methods Data for 912 systemic sclerosis patients assessed between 2000 and 2020 were retrieved from the Assessing the Spectrum of Pulmonary hypertension Identified at a REferral centre (ASPIRE) registry and classified based on 2022 European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines and multimodality investigations. Results Reduction in pulmonary vascular resistance (PVR) diagnostic threshold to >2 WU resulted in a 19% increase in precapillary PH diagnoses. Patients with PVR ≤2 WU had superior survival to PVR >2–3 WU which was similar to PVR >3–4 WU. Survival in pulmonary arterial hypertension (PAH) was superior to PH associated with lung disease. However, patients with mild parenchymal disease on CT had similar characteristics and outcomes to patients without lung disease. Combined pre- and postcapillary PH had significantly poorer survival than isolated postcapillary PH. Patients with mean pulmonary arterial wedge pressure (PAWP) 13–15 mm Hg had similar haemodynamics and left atrial volumes to those with PAWP >15 mm Hg. Unclassified-PH had more frequently dilated left atria and higher PAWP than PAH. Although Unclassified-PH had a similar survival to No-PH, 36% were subsequently diagnosed with PAH or PH associated with left heart disease. The presence of 2–3 radiological signs of pulmonary veno-occlusive disease was noted in 7% of PAH patients and was associated with worse survival. Improvement in incremental shuttle walking distance of ≥30 m following initiation of PAH therapy was associated with superior survival. PAH patients diagnosed after 2011 had greater use of combination therapy and superior survival. Conclusion A number of systemic sclerosis PH phenotypes can be recognized and characterized using haemodynamics, lung function and multimodality imaging. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| Relation: | https://eprints.whiterose.ac.uk/217209/1/1-s2.0-S1053249824016991-main.pdf; Smith, H., Thompson, A.A.R. orcid.org/0000-0002-0717-4551 , Akil, M. et al. (17 more authors) (2024) The spectrum of systemic sclerosis-associated pulmonary hypertension: Insights from the ASPIRE registry. The Journal of Heart and Lung Transplantation, 43 (10). pp. 1629-1639. ISSN 1053-2498 |
| الاتاحة: | https://eprints.whiterose.ac.uk/217209/ https://eprints.whiterose.ac.uk/217209/1/1-s2.0-S1053249824016991-main.pdf |
| Rights: | cc_by_4 |
| رقم الانضمام: | edsbas.78199D81 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |