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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

Scatter plot of formula predicted pulmonary artery pressure regression model (Adjusted r2=0.969, P=0.000)
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Figure 0008: Scatter plot of formula predicted pulmonary artery pressure regression model (Adjusted r2=0.969, P=0.000)

Mentions: The 95% CI for the model parameter estimates are listed in Table 5. This model explained 96% of the variance of MPAP (adjusted R2 = 0.969, P < 0.000). The model scatter plot of formula-calculated versus model predicted MPAP is shown in Figure 3. Sequential and partial sums of squares associated with the primary predictors demonstrated that SpO2 provided the majority of the predictive information.


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)

Scatter plot of formula predicted pulmonary artery pressure regression model (Adjusted r2=0.969, P=0.000)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0008: Scatter plot of formula predicted pulmonary artery pressure regression model (Adjusted r2=0.969, P=0.000)
Mentions: The 95% CI for the model parameter estimates are listed in Table 5. This model explained 96% of the variance of MPAP (adjusted R2 = 0.969, P < 0.000). The model scatter plot of formula-calculated versus model predicted MPAP is shown in Figure 3. Sequential and partial sums of squares associated with the primary predictors demonstrated that SpO2 provided the majority of the predictive information.

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