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46. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 32. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

19.09. - 22.09.2018, Mannheim

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Borderline pulmonary hypertension was associated with reduced cardiac output during exercise in patients with connective tissue diseases

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  • Alberto Marra - Thoraxklinik Heidelberg, Pneumologie, Heidelberg
  • Christian Nagel - Thoraxklinik Heidelberg, Pneumologie, Heidelberg
  • Benjamin Egenlauf - Thoraxklinik Heidelberg, Pneumologie, Heidelberg
  • Panagiota Xanthouli - Thoraxklinik Heidelberg, Pneumologie, Heidelberg
  • Satenik Harutyunova - Thoraxklinik Heidelberg, Pneumologie, Heidelberg
  • Norbert Blank - Uniklinik Heidelberg, Rheumatologie, Heidelberg
  • Hanns-Martin Lorenz - Uniklinik Heidelberg, Rheumatologie, Heidelberg
  • Christoph Fiehn - ACURA Rheumazentrum Baden-Baden, Baden-Baden
  • Nicola Benjamin - Thoraxklinik Heidelberg, Pneumologie, Studienkoordination, Heidelberg
  • Christine Fischer - Universitätsklinikum Heidelberg, Abteilung für Humangenetik, Heidelberg
  • Eduardo Bossone - Azienda Ospedaliera Universitaria OO.RR. S.Giovanni di Dio e Ruggi d’Aragona, Salerno, Kardiologie, Salerno, Italy
  • Antonio Cittadini - Universität Neapel Federico II, Department of Translational Medical Science, Napoli, Italy
  • Ekkehard Grünig - Thoraxklinik des Universitätsklinikums Heidelberg, Zentrum für pulmonale Hypertonie, Heidelberg

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 46. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 32. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Mannheim, 19.-22.09.2018. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocVK.22

doi: 10.3205/18dgrh203, urn:nbn:de:0183-18dgrh2030

Published: February 5, 2019

© 2019 Marra et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: In patients with systemic sclerosis (SSc) borderline mean pulmonary arterial pressures (mPAP; 21-24 mmHg at rest) are a frequent finding and could represent an intermediate stage between normal pulmonary pressuresand manifest pulmonary hypertension (PH) [1].

The objective of this prospective study was to compare right ventricular function and pulmonary arterial compliance (PAC) at rest and during exercise between systemic sclerosis (SSc)-patients with normal and borderline mean pulmonary artery pressures, respectively.

Methods: SSc-patients (n=112) underwent clinical assessment. including right heart catheterization at rest and during exercise and were divided in three groups according to their resting mPAP values: normal mPAP (≤20 mmHg), borderline mPAP (21-24 mmHg) and manifest pulmonary hypertension (PH, mPAP ≥25 mmHg). Results were compared between groups by ANOVA followed by post-hoc student’s t-test.

Results: SSc Patients with borderline PAP showed significantly lower cardiac index (CI) increase during exercise and higher PVR values than SSc patients with normal PAP at rest. Six-Minute-walking distance (6MWD) and PAC (strokevolume/(systolicPAP-diastolicPAP) were significantly lower in the borderline PAP group compared to patients with normal PAP.

Conclusion: These findings indicate that right ventricular dysfunction during exercise might be an early stage of pulmonary hypertension leading to impaired exercise capacity in patients with connective tissue diseases.