J Cardiovasc Ultrasound.  2016 Dec;24(4):312-316. 10.4250/jcu.2016.24.4.312.

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

• Yoo SJ
• Park JH
• Park Y
• Lee JH
• Sun BJ
• Kim J
• Yoo IS
• Shim SC
• Kang SW

• KMID: 2364649
• DOI: http://doi.org/10.4250/jcu.2016.24.4.312

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.

Keyword

Systemic sclerosis; Pulmonary arterial hypertension; Echocardiography; Right heart catheterization; Screening

MeSH Terms

Adult*
Arterial Pressure
Cardiac Catheterization
Cardiac Catheters
Chungcheongnam-do
Diagnosis
Echocardiography*
Humans
Hypertension*
Mass Screening*
Mortality
Prevalence*
Prognosis
Scleroderma, Systemic*
Tricuspid Valve Insufficiency
Vasodilator Agents
Vasodilator Agents

Figure

• 

  Fig. 1 The flow chart of this study. TR Vmax: maximal velocity of tricuspid regurgitation, PAH: pulmonary arterial hypertension, RHC: right heart catheterization, SSc-PAH: pulmonary arterial hypertension associated with systemic sclerosis.

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