Research Article
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Evaluation of pulmonary artery stiffness in patients with systemic sclerosis

Year 2024, Volume: 37 Issue: 1, 11 - 17, 28.01.2024
https://doi.org/10.5472/marumj.1378484

Abstract

Objective: The study aims to investigate the use of pulmonary artery stiffness (PAS) parameter in early diagnosis of systemic sclerosis
(SSc) and pulmonary hypertension in SSc patients.
Patients and Methods: The study involved 102 SSc patients and 45 control group patients, who underwent transthoracic
echocardiographic evaluations.
Results: Pulmonary artery stiffness was measured as 25.7±7.6 (Hz/msn) in the SSc cases and 13.7 ±1.6 (Hz/msn) in the healthy
subjects (P< 0.001). TAPSE/sPAP ratio, which we used as an indicator of RV-PA coupling, was calculated as 0.65+0.28 in SSc cases and
1.12+0.33 in the control group (P<0.001).
When we evaluated PAS values of subgroups PAS was significantly higher in SScPH(-) patients without pulmonary hypertension than
control subjects (respectively; 21.67 ± 3.9; 13.7 ± 1.6, P<0.001). The relationship of PAS with the parameters in which pulmonary
hypertension and right ventricular functions were evaluated, there was a positive correlation with sPAP( r: – 0.396, P <0.001), while a
negative correlation was observed with TAPSE/sPAP (r: 0.456, P<0.001).
Conclusion: We observed higher PAS values in SScPH(-) patients compared to the control group and found a positive correlation
between the increase in PAS and sPAP and a negative correlation between them and TAPSE/sPAP.

References

  • Mukerjee D, George DS, Coleiro B, et al. Prevalence and outcome in systemic sclerosis-associated pulmonary arterial hypertension: application of a registry approach. Ann Rheum Dis 2003; 62:1088-93. doi: 10.1136/ard.62.11.1088
  • Humbert M, Kovacs G, Hoeper M, et al. ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2022; 43:3618-731. doi: 10.1093/eurheartj/ehac237
  • Coghlan JG, Denton CP, Grünig E, et al. Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study. Ann Rheum Dis 2014; 73:1340- 9. doi: 10.1136/annrheumdis-2013-203301.
  • Rangarajan V, Matiasz R, Freed BH et al. Cardiac complications of systemic sclerosis and management: recent progress. Curr Opin Rheumatol 2017; 9: 574–84. doi:10.1097/ BOR.000.000.0000000439.
  • Brown Z, Proudman S, Morrisroe K, et al. Screening for the early detection of pulmonary arterial hypertension in patients with systemic sclerosis: A systematic review and meta-analysis of long-term outcomes. Semin Arthritis Rheum 2021;51:495- 512. doi:10.1016/j.semarthrit.2021.03.011
  • Horvat D, Zlibut A, Orzan RI, et al. Aging influences pulmonary artery flow and stiffness in healthy individuals: non-invasive assessment using cardiac MRI. Clin Radiol 2021;76:161.e19-161.e28. doi:10.1016/j.crad.2020.09.021
  • van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 2013;72:1747-55. doi:10.1136/annrheumdis-2013-204424
  • Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiograph endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-788. doi:10.1016/j. echo.2010.05.010
  • Colalillo A, Grimaldi MC, Vaiarello V, et al. In systemic sclerosis, the TAPSE/sPAP ratio can be used in addition to the DETECT algorithm for pulmonary arterial hypertension diagnosis. Rheumatology (Oxford) 2022;61:2450-56. doi:10.1093/rheumatology/keab748
  • Görgülü S, Eren M, Yildirim A, et al. A new echocardiographic approach in assessing pulmonary vascular bed in patients with congenital heart disease: pulmonary artery stiffness. Anadolu Kardiyol Derg 2003;3:92-97.
  • Koh ET, Lee P, Gladman DD, Abu-Shakra M. Pulmonary hypertension in systemic sclerosis: an analysis of 17 patients. Br J Rheumatol 1996;35:989-93. doi:10.1093/ rheumatology/35.10.989
  • Belin RJ, Varga J, Collins JD, Freed BH. Right ventricular cardiomyopathy in systemic sclerosis. Rheumatology (Oxford) 2017;56:1045-47. doi:10.1093/rheumatology/kew494
  • Demirci M, Ozben B, Sunbul M, et al. The evaluation of right ventricle dyssynchrony by speckle tracking echocardiography in systemic sclerosis patients. J Clin Ultrasound 2021;49:895- 902. doi:10.1002/jcu.23041
  • Chemla D, Weatherald J, Lau EMT, et al. Clinical and hemodynamic correlates of pulmonary arterial stiffness in incident, untreated patients with idiopathic pulmonary arterial hypertension. Chest 2018;154:882-92. doi:10.1016/j. chest.2018.06.015
  • Kang KW, Chang HJ, Kim YJ, et al. Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension. Circ J 2011;75:2244-51. doi:10.1253/circj.cj-10- 1310
  • Yaşar S, Unlu M, Görmel S, et al. Evaluation of the relationship between pulmonary artery stiffness and right ventricular function in patients with Behçet’s disease using transthoracic echocardiography. Authorea 2021: 2232-36. doi 10.22541/ au.163615.894.48445737/v1
  • Ozkececi G, Ulasli SS, Akci O, et al. Assessment of pulmonary arterial stiffness in obstructive sleep apnea. Int J Cardiovasc Imaging 2016;32:799-805. doi:10.1007/s10554.016.0841-0
  • Baysal SS, Has M. Evaluation of pulmonary artery stiffness in newly diagnosed adult patients with asthma. Echocardiography 2019;36:870-76. doi:10.1111/echo.14309
  • Abacioglu OO, Gulumsek E, Sumbul H, Kaplan M, Yavuz F. Increased pulmonary arterial stiffness and impaired right ventricle-pulmonary artery coupling in PCOS. Arq Bras Cardiol 2021;116:806-11. doi:10.36660/abc.20190762
  • Öz A, Çınar T, Taş E, Çağan Efe S, Ayça B, Karabağ T. Assessment of pulmonary arterial stiffness in patients with cirrhosis: A prospective cohort study. Echocardiography 2021;38:57-63. doi:10.1111/echo.14935
  • Yenerçağ M, Arslan U, Dereli S, Çoksevim M, Doğduş M, Kaya A. Effects of angiotensin receptor neprilysin inhibition on pulmonary arterial stiffness in heart failure with reduced ejection fraction. Int J Cardiovasc Imaging 2021;37:165-73. doi:10.1007/s10554.020.01973-8
  • Duman D, Masatlıoğlu S, Demirtunç R,Karadağ B Increased pulmonary artery stiffness and its relation to right ventricular function in patients with systemic lupus erythematosus. Turk Kardiyoloji Dernegi Arsivi 2008; 36,2:82-9.
  • Cerik IB, Meric M, Gulel O, et al. Echocardiographic assessment of pulmonary arterial stiffness in human immunodeficiency virus-infected patients. Echocardiography 2019;36:1123-31. doi:10.1111/echo.14349
  • Hoffmann-Vold AM, Fretheim H, Midtvedt Q, et al. Frequencies of borderline pulmonary hypertension before and after the DETECT algorithm: results from a prospective systemic sclerosis cohort. Rheumatology (Oxford) 2018;57:480-87. doi:10.1093/rheumatology/kex435
  • Colalillo A, Hoffmann-Vold AM, Pellicano C, et al. The role of TAPSE/sPAP ratio in predicting pulmonary hypertension and mortality in the systemic sclerosis EUSTAR cohort. Autoimmun Rev 2023;22:113-19. doi:10.1016/j. autrev.2023.103290
  • Baptista R, Serra S, Martins R, et al. Exercise echocardiography for the assessment of pulmonary hypertension in systemic sclerosis: a systematic review. Arthritis Res Ther 2016;18:153. doi:10.1186/s13075.016.1051-9
Year 2024, Volume: 37 Issue: 1, 11 - 17, 28.01.2024
https://doi.org/10.5472/marumj.1378484

Abstract

References

  • Mukerjee D, George DS, Coleiro B, et al. Prevalence and outcome in systemic sclerosis-associated pulmonary arterial hypertension: application of a registry approach. Ann Rheum Dis 2003; 62:1088-93. doi: 10.1136/ard.62.11.1088
  • Humbert M, Kovacs G, Hoeper M, et al. ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2022; 43:3618-731. doi: 10.1093/eurheartj/ehac237
  • Coghlan JG, Denton CP, Grünig E, et al. Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study. Ann Rheum Dis 2014; 73:1340- 9. doi: 10.1136/annrheumdis-2013-203301.
  • Rangarajan V, Matiasz R, Freed BH et al. Cardiac complications of systemic sclerosis and management: recent progress. Curr Opin Rheumatol 2017; 9: 574–84. doi:10.1097/ BOR.000.000.0000000439.
  • Brown Z, Proudman S, Morrisroe K, et al. Screening for the early detection of pulmonary arterial hypertension in patients with systemic sclerosis: A systematic review and meta-analysis of long-term outcomes. Semin Arthritis Rheum 2021;51:495- 512. doi:10.1016/j.semarthrit.2021.03.011
  • Horvat D, Zlibut A, Orzan RI, et al. Aging influences pulmonary artery flow and stiffness in healthy individuals: non-invasive assessment using cardiac MRI. Clin Radiol 2021;76:161.e19-161.e28. doi:10.1016/j.crad.2020.09.021
  • van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 2013;72:1747-55. doi:10.1136/annrheumdis-2013-204424
  • Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiograph endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-788. doi:10.1016/j. echo.2010.05.010
  • Colalillo A, Grimaldi MC, Vaiarello V, et al. In systemic sclerosis, the TAPSE/sPAP ratio can be used in addition to the DETECT algorithm for pulmonary arterial hypertension diagnosis. Rheumatology (Oxford) 2022;61:2450-56. doi:10.1093/rheumatology/keab748
  • Görgülü S, Eren M, Yildirim A, et al. A new echocardiographic approach in assessing pulmonary vascular bed in patients with congenital heart disease: pulmonary artery stiffness. Anadolu Kardiyol Derg 2003;3:92-97.
  • Koh ET, Lee P, Gladman DD, Abu-Shakra M. Pulmonary hypertension in systemic sclerosis: an analysis of 17 patients. Br J Rheumatol 1996;35:989-93. doi:10.1093/ rheumatology/35.10.989
  • Belin RJ, Varga J, Collins JD, Freed BH. Right ventricular cardiomyopathy in systemic sclerosis. Rheumatology (Oxford) 2017;56:1045-47. doi:10.1093/rheumatology/kew494
  • Demirci M, Ozben B, Sunbul M, et al. The evaluation of right ventricle dyssynchrony by speckle tracking echocardiography in systemic sclerosis patients. J Clin Ultrasound 2021;49:895- 902. doi:10.1002/jcu.23041
  • Chemla D, Weatherald J, Lau EMT, et al. Clinical and hemodynamic correlates of pulmonary arterial stiffness in incident, untreated patients with idiopathic pulmonary arterial hypertension. Chest 2018;154:882-92. doi:10.1016/j. chest.2018.06.015
  • Kang KW, Chang HJ, Kim YJ, et al. Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension. Circ J 2011;75:2244-51. doi:10.1253/circj.cj-10- 1310
  • Yaşar S, Unlu M, Görmel S, et al. Evaluation of the relationship between pulmonary artery stiffness and right ventricular function in patients with Behçet’s disease using transthoracic echocardiography. Authorea 2021: 2232-36. doi 10.22541/ au.163615.894.48445737/v1
  • Ozkececi G, Ulasli SS, Akci O, et al. Assessment of pulmonary arterial stiffness in obstructive sleep apnea. Int J Cardiovasc Imaging 2016;32:799-805. doi:10.1007/s10554.016.0841-0
  • Baysal SS, Has M. Evaluation of pulmonary artery stiffness in newly diagnosed adult patients with asthma. Echocardiography 2019;36:870-76. doi:10.1111/echo.14309
  • Abacioglu OO, Gulumsek E, Sumbul H, Kaplan M, Yavuz F. Increased pulmonary arterial stiffness and impaired right ventricle-pulmonary artery coupling in PCOS. Arq Bras Cardiol 2021;116:806-11. doi:10.36660/abc.20190762
  • Öz A, Çınar T, Taş E, Çağan Efe S, Ayça B, Karabağ T. Assessment of pulmonary arterial stiffness in patients with cirrhosis: A prospective cohort study. Echocardiography 2021;38:57-63. doi:10.1111/echo.14935
  • Yenerçağ M, Arslan U, Dereli S, Çoksevim M, Doğduş M, Kaya A. Effects of angiotensin receptor neprilysin inhibition on pulmonary arterial stiffness in heart failure with reduced ejection fraction. Int J Cardiovasc Imaging 2021;37:165-73. doi:10.1007/s10554.020.01973-8
  • Duman D, Masatlıoğlu S, Demirtunç R,Karadağ B Increased pulmonary artery stiffness and its relation to right ventricular function in patients with systemic lupus erythematosus. Turk Kardiyoloji Dernegi Arsivi 2008; 36,2:82-9.
  • Cerik IB, Meric M, Gulel O, et al. Echocardiographic assessment of pulmonary arterial stiffness in human immunodeficiency virus-infected patients. Echocardiography 2019;36:1123-31. doi:10.1111/echo.14349
  • Hoffmann-Vold AM, Fretheim H, Midtvedt Q, et al. Frequencies of borderline pulmonary hypertension before and after the DETECT algorithm: results from a prospective systemic sclerosis cohort. Rheumatology (Oxford) 2018;57:480-87. doi:10.1093/rheumatology/kex435
  • Colalillo A, Hoffmann-Vold AM, Pellicano C, et al. The role of TAPSE/sPAP ratio in predicting pulmonary hypertension and mortality in the systemic sclerosis EUSTAR cohort. Autoimmun Rev 2023;22:113-19. doi:10.1016/j. autrev.2023.103290
  • Baptista R, Serra S, Martins R, et al. Exercise echocardiography for the assessment of pulmonary hypertension in systemic sclerosis: a systematic review. Arthritis Res Ther 2016;18:153. doi:10.1186/s13075.016.1051-9
There are 26 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Original Research
Authors

Dursun Akaslan 0000-0001-8741-9610

Murat Demirci 0000-0002-8835-9557

Publication Date January 28, 2024
Published in Issue Year 2024 Volume: 37 Issue: 1

Cite

APA Akaslan, D., & Demirci, M. (2024). Evaluation of pulmonary artery stiffness in patients with systemic sclerosis. Marmara Medical Journal, 37(1), 11-17. https://doi.org/10.5472/marumj.1378484
AMA Akaslan D, Demirci M. Evaluation of pulmonary artery stiffness in patients with systemic sclerosis. Marmara Med J. January 2024;37(1):11-17. doi:10.5472/marumj.1378484
Chicago Akaslan, Dursun, and Murat Demirci. “Evaluation of Pulmonary Artery Stiffness in Patients With Systemic Sclerosis”. Marmara Medical Journal 37, no. 1 (January 2024): 11-17. https://doi.org/10.5472/marumj.1378484.
EndNote Akaslan D, Demirci M (January 1, 2024) Evaluation of pulmonary artery stiffness in patients with systemic sclerosis. Marmara Medical Journal 37 1 11–17.
IEEE D. Akaslan and M. Demirci, “Evaluation of pulmonary artery stiffness in patients with systemic sclerosis”, Marmara Med J, vol. 37, no. 1, pp. 11–17, 2024, doi: 10.5472/marumj.1378484.
ISNAD Akaslan, Dursun - Demirci, Murat. “Evaluation of Pulmonary Artery Stiffness in Patients With Systemic Sclerosis”. Marmara Medical Journal 37/1 (January 2024), 11-17. https://doi.org/10.5472/marumj.1378484.
JAMA Akaslan D, Demirci M. Evaluation of pulmonary artery stiffness in patients with systemic sclerosis. Marmara Med J. 2024;37:11–17.
MLA Akaslan, Dursun and Murat Demirci. “Evaluation of Pulmonary Artery Stiffness in Patients With Systemic Sclerosis”. Marmara Medical Journal, vol. 37, no. 1, 2024, pp. 11-17, doi:10.5472/marumj.1378484.
Vancouver Akaslan D, Demirci M. Evaluation of pulmonary artery stiffness in patients with systemic sclerosis. Marmara Med J. 2024;37(1):11-7.