Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis |
| |
Authors: | Hamada Kunio Nagai Sonoko Tanaka Shigeru Handa Tomohiro Shigematsu Michio Nagao Taishi Mishima Michiaki Kitaichi Masanori Izumi Takateru |
| |
Affiliation: | Division of Internal Medicine, Chitose City Hospital, Hokko 2-1-1, Chitose, Hokkaido, Japan. kunio.hamada@city.chitose.hokkaido.jp |
| |
Abstract: | STUDY OBJECTIVES: To evaluate the long-term clinical course of patients with idiopathic pulmonary fibrosis (IPF) complicated with pulmonary arterial hypertension. DESIGN: Prospective analysis of consecutive IPF patients undergoing initial workup with right-heart catheterization (RHC) and pulmonary function testing (PFT). Pulmonary arterial pressure (PAP) and diffusion capacity of the lung for carbon monoxide (Dlco) were focused on. SETTING: University hospital. PATIENTS: Seventy-eight patients with IPF (67 men, 11 women; diagnosis by pathology, n = 59; clinical diagnosis, n = 19) had been followed up after initial workup for a maximum of 14 years. MEASUREMENTS AND RESULTS: RHC data on 61 patients and PFT data on 52 patients were available. Five-year survival rates were 62.2% in the normal-PAP group (mean PAP < 17 mm Hg, n = 37) and 16.7% in the high-PAP group (mean PAP > 17 mm Hg, n = 24) [p < 0.001]; 70.4% in the preserved-Dlco group (percentage of predicted > 40%, n = 27) and 20.0% in the low-Dlco group (percentage of predicted < 40%, n = 25) [p < 0.001]; and 82.6% in group 1 (normal PAP and preserved Dlco, n = 23) and 15.6% in group 2 (high PAP, low Dlco, or both, n = 32) [p < 0.0001]. The relative risks of mortality within 5 years after RHC were 2.20 (95% confidence interval [CI], 1.40 to 3.45) in the high-PAP group, 2.70 (95% CI, 1.46 to 4.99) in the low-Dlco group, and 4.85 (95% CI, 1.97 to 11.97) in group 2. CONCLUSION: Dlco was a critical factor for evaluating disease status and prognosis, and PAP status provided feasible information in the initial workup of IPF patients. |
| |
Keywords: | idiopathic pulmonary fibrosis prognosis pulmonary arterial hypertension CI" },{" #name" :" keyword" ," $" :{" id" :" cekeyw40a" }," $$" :[{" #name" :" text" ," _" :" confidence interval diffusion capacity of the lung for carbon monoxide percentage of predicted diffusion capacity of the lung for carbon monoxide HRCT" },{" #name" :" keyword" ," $" :{" id" :" cekeyw70a" }," $$" :[{" #name" :" text" ," _" :" high-resolution CT ILD" },{" #name" :" keyword" ," $" :{" id" :" cekeyw80a" }," $$" :[{" #name" :" text" ," _" :" interstitial lung disease IPF" },{" #name" :" keyword" ," $" :{" id" :" cekeyw90a" }," $$" :[{" #name" :" text" ," _" :" idiopathic pulmonary fibrosis LTOT" },{" #name" :" keyword" ," $" :{" id" :" cekeyw100a" }," $$" :[{" #name" :" text" ," _" :" long-term oxygen therapy mPAP" },{" #name" :" keyword" ," $" :{" id" :" cekeyw110a" }," $$" :[{" #name" :" text" ," _" :" mean pulmonary arterial pressure PAH" },{" #name" :" keyword" ," $" :{" id" :" cekeyw120a" }," $$" :[{" #name" :" text" ," _" :" pulmonary arterial hypertension PAP" },{" #name" :" keyword" ," $" :{" id" :" cekeyw130a" }," $$" :[{" #name" :" text" ," _" :" pulmonary arterial pressure partial pressure of oxygen in mixed venous blood PFT" },{" #name" :" keyword" ," $" :{" id" :" cekeyw150a" }," $$" :[{" #name" :" text" ," _" :" pulmonary function testing RHC" },{" #name" :" keyword" ," $" :{" id" :" cekeyw160a" }," $$" :[{" #name" :" text" ," _" :" right-heart catheterization USCG" },{" #name" :" keyword" ," $" :{" id" :" cekeyw170a" }," $$" :[{" #name" :" text" ," _" :" ultrasonic cardiography %VC" },{" #name" :" keyword" ," $" :{" id" :" cekeyw180a" }," $$" :[{" #name" :" text" ," _" :" percentage of predicted vital capacity |
本文献已被 ScienceDirect PubMed 等数据库收录! |
|