Open AccessPulmonary hypertension in advanced lung diseases: Echocardiography as an important part of patient evaluation for lung transplantation
Author(s) -
Nowak Jolanta,
Hudzik Bartosz,
Jastrzȩbski Dariusz,
Niedziela Jacek T.,
Rozentryt Piotr,
Wojarski Jacek,
Ochman Marek,
Karolak Wojciech,
Żegleń Sławomir,
Gierlotka Marek,
Gąsior Mariusz
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12608
Subject(s) - medicine , pulmonary hypertension , lung transplantation , cardiology , copd , lung , receiver operating characteristic , interstitial lung disease , idiopathic pulmonary fibrosis , transplantation , ventricular outflow tract
Pulmonary hypertension (PH) is common complication in advanced lung disease. Echocardiography provides additional information and may be useful to assess PH probability. Objectives The usefulness of combination of well‐known echocardiographic parameters in detecting PH in patients with advanced lung disease referred for lung transplantation was evaluated. Methods The study population consisted of 37 consecutive patients with idiopathic pulmonary fibrosis (IPF), 20 patients with chronic obstructive pulmonary disease (COPD), and 8 patients with other interstitial lung diseases. PH was defined as mean pulmonary arterial pressure (mPAP) ≥25 mm Hg diagnosed by cardiac catheterization. Results PH was present in 67.6% of enrolled IPF patients, 30% of enrolled COPD patients, and 75% of patients with other interstitial lung diseases. The receiver operating characteristics (ROC) curve analysis demonstrated right ventricular systolic pressure (RVSP ) ≥43 mm Hg to be the threshold for PH prediction (n = 37, sensitivity 92.3%, specificity 81.8%, area under curve (AUC) 0.84, 95% confidence interval (CI) 0.67‐1.0; P = .019). Right ventricular outflow tract (RVOT) diameter ≥34 mm and tricuspid annular plane systolic excursion (TAPSE) ≤18 mm had acceptable sensitivity, specificity and AUC (n = 65, 62.2%, 89.3%, 0.77, 95% CI 0.66‐0.89; P = .11 and n = 62, 77.1%, 66.7%, 0.74, CI 0.61‐0.87; P = .27, respectively). Combination of RVSP, RVOT and TAPSE, obtained in 36 patients, increased the sensitivity and negative predictive value (NPV) to 100%. Conclusions In patients with advanced lung diseases referred for lung transplantation the combination of RVSP, RVOT diameter, and TAPSE may be helpful in PH exclusion.