Reduced diffusing capacity for carbon monoxide predicts borderline pulmonary arterial pressure in patients with systemic sclerosis

Ninagawa, Keita; Kato, Masaru; Nakamura, Hiroyuki; Abe, Nobuya; Kono, Michihito; Fujieda, Yuichiro; Oku, Kenji; Yasuda, Shinsuke; Ohira, Hiroshi; Tsujino, Ichizo; Atsumi, Tatsuya

Reduced diffusing capacity for carbon monoxide predicts borderline pulmonary arterial pressure in patients with systemic sclerosis

Ninagawa, Keita; Kato, Masaru; Nakamura, Hiroyuki et al.

Rheumatology international, 2019, 39(11), 1883-1887

Permalink : https://hdl.handle.net/2115/79648

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/79648
タイトル	Reduced diffusing capacity for carbon monoxide predicts borderline pulmonary arterial pressure in patients with systemic sclerosis
著者	Ninagawa, Keita ; Kato, Masaru ; Nakamura, Hiroyuki ; Abe, Nobuya ; Kono, Michihito ; Fujieda, Yuichiro ; Oku, Kenji ; Yasuda, Shinsuke ; Ohira, Hiroshi ; Tsujino, Ichizo ; Atsumi, Tatsuya
著者名 Ninagawa, Keita
e-Rad_Researcher 10755896 著者名 Kato, Masaru
著者名 Nakamura, Hiroyuki
著者名 Abe, Nobuya
e-Rad_Researcher 00835192 著者名 Kono, Michihito
e-Rad_Researcher 70790872 著者名 Fujieda, Yuichiro
e-Rad_Researcher 70544295 著者名 Oku, Kenji
e-Rad_Researcher 00374231 著者名 Yasuda, Shinsuke
e-Rad_Researcher 20528301 著者名 Ohira, Hiroshi
e-Rad_Researcher 00344507 著者名 Tsujino, Ichizo
e-Rad_Researcher 20301905 著者名 Atsumi, Tatsuya
言語	英語
キーワード	Pulmonary arterial hypertension
	Systemic sclerosis
	Screening
	FVC
	DLCO
発行日	2019-11
出版者	Springer
収録物名	Rheumatology international
巻(号)	39(11)
ページ	1883-1887
抄録	Early intervention in pulmonary arterial hypertension associated with systemic sclerosis (SSc) may improve its prognosis. We aimed to establish an algorithm to detect mean pulmonary artery pressure (mPAP) > 20 mmHg using non-invasive examinations in SSc patients by modifying the DETECT algorithm. This study included SSc patients who underwent right heart catheterization (RHC) in our hospital during 2010-2018. Following variables were assessed for performance to predict mPAP >= 25 mmHg or > 20 mmHg; anti-centromere or U1-RNP antibody, plasma BNP level, serum urate level, right axis deviation, forced vital capacity (FVC)/diffusing capacity for carbon monoxide (DLCO) ratio, and tricuspid regurgitation velocity. Of 58 patients enrolled in this study, 24 had mPAP of >= 25 mmHg and 9 had mPAP of 21-24 mmHg. Among variables tested, only FVC/DLCO elevated similarly in patients with mPAP of >= 25 mmHg (median 2.5) and those with mPAP of 21-24 mmHg (median 2.5) compared to those with mPAP of <= 20 mmHg (median 1.5). Given the particularly good correlation between DLCO and mPAP of > 20 mmHg, each variable was weighted according to its odds ratio and the total weighted score was calculated. The total weighted score exhibited a good predictive performance for mPAP of > 20 mmHg with its sensitivity of 87.5% and specificity of 92%. Among conventional risk factors for PAH, decreased DLCO may predict mPAP > 20 mmHg with priority in SSc patients. Weighting DLCO may improve the performance of screening algorithm for early SSc-PAH.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This is a post-peer-review, pre-copyedit version of an article published in Rheumatology international. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00296-019-04370-0
PISSN	0172-8172
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00296-019-04370-0