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Evaluation of recently validated non- invasive formula using basic lung functions as new screening tool for pulmonary hypertension in idiopathic pulmonary fibrosis patients.

Ghanem MK, Makhlouf HA, Agmy GR, Imam HM, Fouad DA - Ann Thorac Med (2009)

Bottom Line: There was no statistically significant difference in the prediction of PH using cut off point of 21 or 25 mm Hg (P = 0.24).The formula-predicted MPAP greater than 25 mm Hg strongly correlated in the expected direction with O₂ saturation (r = -0.95, P < 0.000), partial arterial O₂tension (r = -0.71, P < 0.000), right ventricular systolic pressure measured by TTE (r = 0.6, P < 0.000) and hilar width on CXR (r = 0.31, P = 0.03).Chest symptoms, ECG and CTPA signs of PH poorly correlated with the same formula (P > 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Chest Disease, Faculty of Medicine, Assiut University Hospital, Assiut - 71111, Egypt. mahaghanem@hotmail.com

ABSTRACT

Background: A prediction formula for mean pulmonary artery pressure (MPAP) using standard lung function measurement has been recently validated to screen for pulmonary hypertension (PH) in idiopathic pulmonary fibrosis (IPF) patients.

Objective: To test the usefulness of this formula as a new non invasive screening tool for PH in IPF patients. Also, to study its correlation with patients' clinical data, pulmonary function tests, arterial blood gases (ABGs) and other commonly used screening methods for PH including electrocardiogram (ECG), chest X ray (CXR), trans-thoracic echocardiography (TTE) and computerized tomography pulmonary angiography (CTPA).

Materials and methods: Cross-sectional study of 37 IPF patients from tertiary hospital. The accuracy of MPAP estimation was assessed by examining the correlation between the predicted MPAP using the formula and PH diagnosed by other screening tools and patients' clinical signs of PH.

Results: There was no statistically significant difference in the prediction of PH using cut off point of 21 or 25 mm Hg (P = 0.24). The formula-predicted MPAP greater than 25 mm Hg strongly correlated in the expected direction with O₂ saturation (r = -0.95, P < 0.000), partial arterial O₂tension (r = -0.71, P < 0.000), right ventricular systolic pressure measured by TTE (r = 0.6, P < 0.000) and hilar width on CXR (r = 0.31, P = 0.03). Chest symptoms, ECG and CTPA signs of PH poorly correlated with the same formula (P > 0.05).

Conclusions: The prediction formula for MPAP using standard lung function measurements is a simple non invasive tool that can be used as TTE to screen for PH in IPF patients and select those who need right heart catheterization.

No MeSH data available.


Related in: MedlinePlus

Equation diagnosed pulmonary hypertension in relation to resting room O2 saturation in 37 patients with idiopathic pulmonary fibrosis
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Figure 0002: Equation diagnosed pulmonary hypertension in relation to resting room O2 saturation in 37 patients with idiopathic pulmonary fibrosis

Mentions: Formula-predicted patients with and without PH did not differ with respect to age, gender, smoking history, chest symptoms and clinical signs of cor pulmonale or PH [Table 3]. As expected, those with formula-predicted PH had significantly lower DLco [Figure 1a] and resting room air oxygen saturation SpO2 [Figure 1b] and partial arterial oxygen tension (PaO2) tension and significantly higher FVC% pred/ DLCO% pred [Figure 1c] and formula-predicted MPAP and TTE measured RVSP [Figure 1d] than those without PH [Figure 1]. However, they did not perform significantly worse on the rest of spirometry data. CXR and CT-derived scores suggestive of PH did not differ significantly between those with or without formula-predicted PH [Table 3].


Evaluation of recently validated non- invasive formula using basic lung functions as new screening tool for pulmonary hypertension in idiopathic pulmonary fibrosis patients.

Ghanem MK, Makhlouf HA, Agmy GR, Imam HM, Fouad DA - Ann Thorac Med (2009)

Equation diagnosed pulmonary hypertension in relation to resting room O2 saturation in 37 patients with idiopathic pulmonary fibrosis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2801043&req=5

Figure 0002: Equation diagnosed pulmonary hypertension in relation to resting room O2 saturation in 37 patients with idiopathic pulmonary fibrosis
Mentions: Formula-predicted patients with and without PH did not differ with respect to age, gender, smoking history, chest symptoms and clinical signs of cor pulmonale or PH [Table 3]. As expected, those with formula-predicted PH had significantly lower DLco [Figure 1a] and resting room air oxygen saturation SpO2 [Figure 1b] and partial arterial oxygen tension (PaO2) tension and significantly higher FVC% pred/ DLCO% pred [Figure 1c] and formula-predicted MPAP and TTE measured RVSP [Figure 1d] than those without PH [Figure 1]. However, they did not perform significantly worse on the rest of spirometry data. CXR and CT-derived scores suggestive of PH did not differ significantly between those with or without formula-predicted PH [Table 3].

Bottom Line: There was no statistically significant difference in the prediction of PH using cut off point of 21 or 25 mm Hg (P = 0.24).The formula-predicted MPAP greater than 25 mm Hg strongly correlated in the expected direction with O₂ saturation (r = -0.95, P < 0.000), partial arterial O₂tension (r = -0.71, P < 0.000), right ventricular systolic pressure measured by TTE (r = 0.6, P < 0.000) and hilar width on CXR (r = 0.31, P = 0.03).Chest symptoms, ECG and CTPA signs of PH poorly correlated with the same formula (P > 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Chest Disease, Faculty of Medicine, Assiut University Hospital, Assiut - 71111, Egypt. mahaghanem@hotmail.com

ABSTRACT

Background: A prediction formula for mean pulmonary artery pressure (MPAP) using standard lung function measurement has been recently validated to screen for pulmonary hypertension (PH) in idiopathic pulmonary fibrosis (IPF) patients.

Objective: To test the usefulness of this formula as a new non invasive screening tool for PH in IPF patients. Also, to study its correlation with patients' clinical data, pulmonary function tests, arterial blood gases (ABGs) and other commonly used screening methods for PH including electrocardiogram (ECG), chest X ray (CXR), trans-thoracic echocardiography (TTE) and computerized tomography pulmonary angiography (CTPA).

Materials and methods: Cross-sectional study of 37 IPF patients from tertiary hospital. The accuracy of MPAP estimation was assessed by examining the correlation between the predicted MPAP using the formula and PH diagnosed by other screening tools and patients' clinical signs of PH.

Results: There was no statistically significant difference in the prediction of PH using cut off point of 21 or 25 mm Hg (P = 0.24). The formula-predicted MPAP greater than 25 mm Hg strongly correlated in the expected direction with O₂ saturation (r = -0.95, P < 0.000), partial arterial O₂tension (r = -0.71, P < 0.000), right ventricular systolic pressure measured by TTE (r = 0.6, P < 0.000) and hilar width on CXR (r = 0.31, P = 0.03). Chest symptoms, ECG and CTPA signs of PH poorly correlated with the same formula (P > 0.05).

Conclusions: The prediction formula for MPAP using standard lung function measurements is a simple non invasive tool that can be used as TTE to screen for PH in IPF patients and select those who need right heart catheterization.

No MeSH data available.


Related in: MedlinePlus