SAPHIRE: Stress and Pulmonary Hypertension in Rheumatoid Evaluation-A Prevalence Study

Overview

Journal Int J Rheumatol

Publisher Wiley

Specialty Rheumatology

Date 2016 May 21

PMID 27200094

Citations 2

Authors

G E M Reeves

N Collins

P Hayes

J Knapp

M Squance

H Tran

B Bastian

Affiliations

Soon will be listed here.

Abstract

Pulmonary artery hypertension (PAH) is a disorder of elevated resistance in the pulmonary arterial vessels, reflected by elevation of measured pulmonary artery pressure (PAP), and presenting with breathlessness and, if untreated, progressing to right heart failure and death. The heightened prevalence of PAH in populations with underlying systemic autoimmune conditions, particularly scleroderma and its variants, is well recognised, consistent with the proposed autoimmune contribution to PAH pathogenesis, along with disordered thrombotic, inflammatory, and mitogenic factors. Rheumatoid arthritis (RA) is one of a group of systemic autoimmune conditions featuring inflammatory symmetrical erosive polyarthropathy as its hallmark. This study explored the prevalence of PAH in a population of unselected individuals with RA, using exercise echocardiography (EchoCG). The high prevalence of EchoCG-derived elevation of PAP (EDEPP) in this population (14%) suggests that, like other autoimmune conditions, RA may be a risk factor for PAH. Patients with RA may therefore represent another population for whom PAH screening with noninvasive tools such as EchoCG may be justified.

Citing Articles

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References

Hachulla E, Gressin V, Guillevin L, Carpentier P, Diot E, Sibilia J . Early detection of pulmonary arterial hypertension in systemic sclerosis: a French nationwide prospective multicenter study. Arthritis Rheum. 2005; 52(12):3792-800. DOI: 10.1002/art.21433. View

McGoon M, Gutterman D, Steen V, Barst R, McCrory D, Fortin T . Screening, early detection, and diagnosis of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest. 2004; 126(1 Suppl):14S-34S. DOI: 10.1378/chest.126.1_suppl.14S. View

Kovacs G, Berghold A, Scheidl S, Olschewski H . Pulmonary arterial pressure during rest and exercise in healthy subjects: a systematic review. Eur Respir J. 2009; 34(4):888-94. DOI: 10.1183/09031936.00145608. View

Gopal D, Doldt B, Finch K, Simms R, Farber H, Gokce N . Relation of novel echocardiographic measures to invasive hemodynamic assessment in scleroderma-associated pulmonary arterial hypertension. Arthritis Care Res (Hoboken). 2014; 66(9):1386-94. PMC: 4204737. DOI: 10.1002/acr.22307. View

Galie N, Hoeper M, Humbert M, Torbicki A, Vachiery J, Barbera J . Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the.... Eur Heart J. 2009; 30(20):2493-537. DOI: 10.1093/eurheartj/ehp297. View

Mouthon L, Guillevin L, Humbert M . Pulmonary arterial hypertension: an autoimmune disease?. Eur Respir J. 2005; 26(6):986-8. DOI: 10.1183/09031936.05.00112105. View

Humbert M, Coghlan J, Khanna D . Early detection and management of pulmonary arterial hypertension. Eur Respir Rev. 2012; 21(126):306-12. PMC: 9487225. DOI: 10.1183/09059180.00005112. View

Dawson J, Goodson N, Graham D, Lynch M . Raised pulmonary artery pressures measured with Doppler echocardiography in rheumatoid arthritis patients. Rheumatology (Oxford). 2001; 39(12):1320-5. DOI: 10.1093/rheumatology/39.12.1320. View

Ekdahl C, Broman G . Muscle strength, endurance, and aerobic capacity in rheumatoid arthritis: a comparative study with healthy subjects. Ann Rheum Dis. 1992; 51(1):35-40. PMC: 1004615. DOI: 10.1136/ard.51.1.35. View

10.

Udayakumar N, Venkatesan S, Rajendiran C . Pulmonary hypertension in rheumatoid arthritis--relation with the duration of the disease. Int J Cardiol. 2007; 127(3):410-2. DOI: 10.1016/j.ijcard.2007.04.084. View

11.

Homma A, Anzueto A, Peters J, Susanto I, Sako E, Zabalgoitia M . Pulmonary artery systolic pressures estimated by echocardiogram vs cardiac catheterization in patients awaiting lung transplantation. J Heart Lung Transplant. 2001; 20(8):833-9. DOI: 10.1016/s1053-2498(01)00274-1. View

12.

Condliffe R, Kiely D, Peacock A, Corris P, Gibbs J, Vrapi F . Connective tissue disease-associated pulmonary arterial hypertension in the modern treatment era. Am J Respir Crit Care Med. 2008; 179(2):151-7. DOI: 10.1164/rccm.200806-953OC. View

13.

Young I, Ford S, Ford P . The association of pulmonary hypertension with rheumatoid arthritis. J Rheumatol. 1989; 16(9):1266-9. View

14.

Codullo V, Caporali R, Cuomo G, Ghio S, DAlto M, Fusetti C . Stress Doppler echocardiography in systemic sclerosis: evidence for a role in the prediction of pulmonary hypertension. Arthritis Rheum. 2013; 65(9):2403-11. DOI: 10.1002/art.38043. View

15.

Prabu A, Patel K, Yee C, Nightingale P, Situnayake R, Thickett D . Prevalence and risk factors for pulmonary arterial hypertension in patients with lupus. Rheumatology (Oxford). 2009; 48(12):1506-11. DOI: 10.1093/rheumatology/kep203. View

16.

DAlto M, Ghio S, DAndrea A, Pazzano A, Argiento P, Camporotondo R . Inappropriate exercise-induced increase in pulmonary artery pressure in patients with systemic sclerosis. Heart. 2010; 97(2):112-7. DOI: 10.1136/hrt.2010.203471. View

17.

Farber H, Foreman A, Miller D, McGoon M . REVEAL Registry: correlation of right heart catheterization and echocardiography in patients with pulmonary arterial hypertension. Congest Heart Fail. 2011; 17(2):56-64. DOI: 10.1111/j.1751-7133.2010.00202.x. View

18.

Nicolls M, Taraseviciene-Stewart L, Rai P, Badesch D, Voelkel N . Autoimmunity and pulmonary hypertension: a perspective. Eur Respir J. 2005; 26(6):1110-8. DOI: 10.1183/09031936.05.00045705. View

19.

Collins N, Bastian B, Quiqueree L, Jones C, Morgan R, Reeves G . Abnormal pulmonary vascular responses in patients registered with a systemic autoimmunity database: Pulmonary Hypertension Assessment and Screening Evaluation using stress echocardiography (PHASE-I). Eur J Echocardiogr. 2006; 7(6):439-46. DOI: 10.1016/j.euje.2005.12.002. View

20.

Kobak S, Kalkan S, Kirilmaz B, Orman M, Ercan E . Pulmonary Arterial Hypertension in Patients with Primary Sjögren's Syndrome. Autoimmune Dis. 2014; 2014:710401. PMC: 3912822. DOI: 10.1155/2014/710401. View