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Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis.
- Source :
-
Chest [Chest] 2007 Mar; Vol. 131 (3), pp. 650-656. Date of Electronic Publication: 2007 Feb 22. - Publication Year :
- 2007
-
Abstract
- Study Objectives: To evaluate the long-term clinical course of patients with idiopathic pulmonary fibrosis (IPF) complicated with pulmonary arterial hypertension.<br />Design: Prospective analysis of consecutive IPF patients undergoing initial workup with right-heart catheterization (RHC) and pulmonary function testing (PFT). Pulmonary arterial pressure (PAP) and diffusion capacity of the lung for carbon monoxide (Dlco) were focused on.<br />Setting: University hospital.<br />Patients: Seventy-eight patients with IPF (67 men, 11 women; diagnosis by pathology, n = 59; clinical diagnosis, n = 19) had been followed up after initial workup for a maximum of 14 years.<br />Measurements and Results: RHC data on 61 patients and PFT data on 52 patients were available. Five-year survival rates were 62.2% in the normal-PAP group (mean PAP < 17 mm Hg, n = 37) and 16.7% in the high-PAP group (mean PAP > 17 mm Hg, n = 24) [p < 0.001]; 70.4% in the preserved-Dlco group (percentage of predicted > 40%, n = 27) and 20.0% in the low-Dlco group (percentage of predicted < 40%, n = 25) [p < 0.001]; and 82.6% in group 1 (normal PAP and preserved Dlco, n = 23) and 15.6% in group 2 (high PAP, low Dlco, or both, n = 32) [p < 0.0001]. The relative risks of mortality within 5 years after RHC were 2.20 (95% confidence interval [CI], 1.40 to 3.45) in the high-PAP group, 2.70 (95% CI, 1.46 to 4.99) in the low-Dlco group, and 4.85 (95% CI, 1.97 to 11.97) in group 2.<br />Conclusion: Dlco was a critical factor for evaluating disease status and prognosis, and PAP status provided feasible information in the initial workup of IPF patients.
- Subjects :
- Aged
Cardiac Catheterization
Feasibility Studies
Female
Follow-Up Studies
Humans
Hypertension, Pulmonary mortality
Hypertension, Pulmonary physiopathology
Male
Middle Aged
Oxygen blood
Predictive Value of Tests
Prognosis
Prospective Studies
Pulmonary Fibrosis mortality
Pulmonary Fibrosis physiopathology
Survival Rate
Vital Capacity physiology
Hypertension, Pulmonary diagnosis
Pulmonary Diffusing Capacity physiology
Pulmonary Fibrosis diagnosis
Pulmonary Wedge Pressure physiology
Subjects
Details
- Language :
- English
- ISSN :
- 0012-3692
- Volume :
- 131
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Chest
- Publication Type :
- Academic Journal
- Accession number :
- 17317730
- Full Text :
- https://doi.org/10.1378/chest.06-1466