FRI0448 PAH Risk Calculator (Detect), Besides SSC-PAH, Reveals SSC Patients with Borderline and Exercise-Induced PH. (9th June 2015)

• Record Type: Journal Article
• Authors: Volkov, A.; Yudkina, N.; Kurmukov, I.; Nikolaeva, E.
• Is Part Of: Annals of the rheumatic diseases. Volume 74(2015)Supplement 2
• Page Start: 589
• Page End: 590
• Publication Date: 2015-06-09
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2015-eular.6383
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Early diagnostics PAH, associated with SSc is very important, due to devastating nature of the disease. Borderline and exercise-induced PH is a condition thought to represent early-stage pulmonary arterial vasculopathy. Methods: We selected 21 patients with SSc (age 52+10 years, all female) with normal resting mean PAP (17 (14;21) mm Hg) who underwent graded bicycle supine exercise right heart catheterization (RHC). Patients were included in this study if they had 1) a pulmonary artery wedge pressure (PAWP) ≤15 mmHg by RHC; 2) no significant interstitial lung disease; 3) no left heart diseases like systemic hypertension, ischemic heart disease etc. Mean pulmonary artery pressure (mPAP), cardiac output (CO), and others were estimated invasively. Cut-off values of mean PAP ≥30 mm Hg at peak exercise were considered exercise-induced pulmonary hypertension (EI-PH), mean PAP 21-24 mm Hg so-called borderline pulmonary hypertension (Bo-PH). The risk of PAH development was calculated by DETECT PAH risk calculator. Results: 11 of 21 pts had risk factors by DETECT calculator. We didn't find PH at rest RHC in none of 21 pts. 6 SSc pts had mPAP level between 21-24 mm.Hg. 10 (48%) patients showed EI-PH (median level of mPAP =36 (32; 42) mm Hg), 7 hadn't changes in pressure follow exercises. 4 pts were excluded due to low exercise tolerance. We revealed significant correlation between the level of mPAP and DETECT total risk score (r=0, 55, p<0, 01). We found that patients with EI-PH had significantly higher DETECT PAH risk score than patients without EI-PH (38 (27; 42) vs 25 (16; 35), p<0, 05). Calculated level of PAH risk in both DETECT steps were also different depending on existence Bo-PH (41 (34; 43) vs 28 (25; 36), p<0, 02). Conclusions: Our small study assume that DETECT PAH risk calculator also may help to recognize SSc patients who have preclinical stage of PAH. References: Coghlan JC, Denton CP, Grünig E, et al. Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study. Ann Rheum Dis 2014;73:1340–1349. Saggar R. et al. Exercise-Induced Pulmonary Hypertension Associated With Systemic Sclerosis. Arthritis & Rheumatism, 2010, v.62(12), pp.3741-3750. Disclosure of Interest: None declared