Prevalence of Pulmonary Arterial Hypertension in Korean Adult Patients with Systemic Sclerosis: Result of a Pilot Echocardiographic Screening Study.

Journal of cardiovascular ultrasound Pub Date : 2016-12-01 Epub Date: 2016-12-28 DOI:10.4250/jcu.2016.24.4.312
Su-Jin Yoo, Jae-Hyeong Park, Yunseon Park, Jae-Hwan Lee, Byung-Joo Sun, Jinhyun Kim, In Seol Yoo, Seung Cheol Shim, Seong Wook Kang
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Abstract

Background: Pulmonary arterial hypertension (PAH) is a major cause of morbidity and mortality among patients with systemic sclerosis (SSc). Early detection and prompt treatment of PAH associated with SSc (SSc-PAH) result in better prognosis. We conducted echocardiographic study to presume the prevalence of PAH in Korean adult SSc patients and to diagnose SSc-PAH in their early stages with right heart catheterization (RHC).

Methods: We performed free of charge echocardiographic study including 37 adult SSc patients at the Chungnam National University Hospital. The possibility of PAH is determined by the estimation of pulmonary arterial pressure by peak tricuspid regurgitation velocity of > 3.0 m/s. Patients with possible PAH were recommended to undergo RHC to confirm the diagnosis.

Results: In 37 patients, 8 patients were suspected with PAH. Among them, 6 patients agreed to be examined with RHC, and 4 were confirmed with PAH. The prevalence of possible PAH was 21.6% (8 of 37 patients), and that of confirmed PAH was 10.8% (4 of 37 patients). Four patients who were confirmed with SSc-PAH through RHC have been treated with specific pulmonary vasodilators and maintained stable.

Conclusion: Eight patients (21.6%) were possible PAH and 4 (10.8%) were diagnosed as SSc-PAH by RHC after the echocardiographic screening study of 37 adult SSc patients.

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韩国成年系统性硬化症患者肺动脉高压的患病率:超声心动图筛选研究的结果
背景肺动脉高压(PAH)是系统性硬化症(SSc)患者发病和死亡的主要原因。早期发现并及时治疗伴有SSc的PAH (SSc-PAH)预后较好。我们通过超声心动图研究推测韩国成年SSc患者中PAH的患病率,并通过右心导管(RHC)在早期诊断SSc-PAH。方法在忠南大学医院对37例成人SSc患者进行免费超声心动图研究。通过三尖瓣峰值反流速度> 3.0 m/s估计肺动脉压来判断PAH的可能性。建议可能为PAH的患者行RHC以确认诊断。结果37例患者中,8例疑似PAH。其中6例同意接受RHC检查,4例确诊为PAH。37例患者中可能的PAH患病率为21.6%(8例),确诊的PAH患病率为10.8%(37例患者中4例)。4例经RHC确诊为SSc-PAH的患者均经特异性肺血管扩张剂治疗,病情保持稳定。结论37例成人SSc超声心动图筛查结果显示,8例(21.6%)可能为PAH, 4例(10.8%)经RHC诊断为SSc-PAH。
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