Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection
Abstract Pulmonary hypertension (PH) complicates the treatment of interstitial lung disease (ILD) patients resulting in poor functional status and worse outcomes. Early recognition of PH in ILD is important for initiating therapy and considering lung transplantation. However, no standard exists rega...
| Príomhchruthaitheoirí: | , , , |
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| Formáid: | Alt |
| Teanga: | English |
| Foilsithe / Cruthaithe: |
Wiley
2022-10-01
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| Sraith: | Pulmonary Circulation |
| Ábhair: | |
| Rochtain ar líne: | https://doi.org/10.1002/pul2.12141 |
| _version_ | 1828085428109967360 |
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| author | Raj Parikh Ippokratis Konstantinidis David M. O'Sullivan Harrison W. Farber |
| author_facet | Raj Parikh Ippokratis Konstantinidis David M. O'Sullivan Harrison W. Farber |
| author_sort | Raj Parikh |
| collection | DOAJ |
| description | Abstract Pulmonary hypertension (PH) complicates the treatment of interstitial lung disease (ILD) patients resulting in poor functional status and worse outcomes. Early recognition of PH in ILD is important for initiating therapy and considering lung transplantation. However, no standard exists regarding which patients to screen for PH‐ILD or the optimal method to do so. The aim of this study was to create a risk assessment tool that could reliably predict PH in ILD patients. We developed a PH‐ILD Detection tool that incorporated history, exam, 6‐min walk distance, diffusion capacity for carbon monoxide, chest imaging, and cardiac biomarkers to create an eight‐component score. This tool was analyzed retrospectively in 154 ILD patients where each patient was given a score ranging from 0 to 12. The sensitivity (SN) and specificity (SP) of the PH‐ILD Detection tool and an area‐under‐the‐curve (AUC) were calculated. In this cohort, 74 patients (48.1%) had PH‐ILD. A score of ≥6 on the PH‐ILD Detection tool was associated with a diagnosis of PH‐ILD (SN: 86.5%; SP: 86.3%; area‐under‐the‐curve: 0.920, p < 0.001). The PH‐ILD Detection tool provides high SN and SP for detecting PH in ILD patients. With confirmation in larger cohorts, this tool could improve the diagnosis of PH in ILD and may suggest further testing with right heart catheterization and earlier intervention with inhaled treprostinil and/or lung transplant evaluation. |
| first_indexed | 2024-04-11T04:39:52Z |
| format | Article |
| id | doaj.art-1c10c38b51ba460eb8b7fa85a58f44c0 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-11T04:39:52Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-1c10c38b51ba460eb8b7fa85a58f44c02022-12-28T07:32:42ZengWileyPulmonary Circulation2045-89402022-10-01124n/an/a10.1002/pul2.12141Pulmonary hypertension in patients with interstitial lung disease: a tool for early detectionRaj Parikh0Ippokratis Konstantinidis1David M. O'Sullivan2Harrison W. Farber3Division of Pulmonary, Critical Care, and Sleep Hartford Hospital Hartford Connecticut USADepartment of Internal Medicine University of Connecticut Farmington Connecticut USADepartment of Research Administration Hartford HealthCare Hartford Connecticut USADivision of Pulmonary, Sleep and Critical Care Medicine Tufts Medical Center Boston Massachusetts USAAbstract Pulmonary hypertension (PH) complicates the treatment of interstitial lung disease (ILD) patients resulting in poor functional status and worse outcomes. Early recognition of PH in ILD is important for initiating therapy and considering lung transplantation. However, no standard exists regarding which patients to screen for PH‐ILD or the optimal method to do so. The aim of this study was to create a risk assessment tool that could reliably predict PH in ILD patients. We developed a PH‐ILD Detection tool that incorporated history, exam, 6‐min walk distance, diffusion capacity for carbon monoxide, chest imaging, and cardiac biomarkers to create an eight‐component score. This tool was analyzed retrospectively in 154 ILD patients where each patient was given a score ranging from 0 to 12. The sensitivity (SN) and specificity (SP) of the PH‐ILD Detection tool and an area‐under‐the‐curve (AUC) were calculated. In this cohort, 74 patients (48.1%) had PH‐ILD. A score of ≥6 on the PH‐ILD Detection tool was associated with a diagnosis of PH‐ILD (SN: 86.5%; SP: 86.3%; area‐under‐the‐curve: 0.920, p < 0.001). The PH‐ILD Detection tool provides high SN and SP for detecting PH in ILD patients. With confirmation in larger cohorts, this tool could improve the diagnosis of PH in ILD and may suggest further testing with right heart catheterization and earlier intervention with inhaled treprostinil and/or lung transplant evaluation.https://doi.org/10.1002/pul2.12141idiopathic pulmonary fibrosisinterstitial lung diseaseprostacyclinpulmonary hypertensiontreprostinil |
| spellingShingle | Raj Parikh Ippokratis Konstantinidis David M. O'Sullivan Harrison W. Farber Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection Pulmonary Circulation idiopathic pulmonary fibrosis interstitial lung disease prostacyclin pulmonary hypertension treprostinil |
| title | Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection |
| title_full | Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection |
| title_fullStr | Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection |
| title_full_unstemmed | Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection |
| title_short | Pulmonary hypertension in patients with interstitial lung disease: a tool for early detection |
| title_sort | pulmonary hypertension in patients with interstitial lung disease a tool for early detection |
| topic | idiopathic pulmonary fibrosis interstitial lung disease prostacyclin pulmonary hypertension treprostinil |
| url | https://doi.org/10.1002/pul2.12141 |
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