Haemodynamics and serial risk assessment ...
Document type :
Article dans une revue scientifique: Article original
Title :
Haemodynamics and serial risk assessment in systemic sclerosis associated pulmonary arterial hypertension
Author(s) :
Weatherald, Jason [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Hôpital Bicêtre
Boucly, Athénaïs [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 - Faculté de médecine [UP11 UFR Médecine]
Launay, David [Auteur]
Service de médecine interne [Lille]
Lille Inflammation Research International Center - U 995 [LIRIC]
Cottin, Vincent [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Hôpital Louis Pradel [CHU - HCL]
Prévot, Grégoire [Auteur]
Service Pneumologie-Allergologie [CHU Toulouse]
Bourlier, Delphine [Auteur]
Dauphin, Claire [Auteur]
CHU Clermont-Ferrand
Service Médecine Interne - site Gabriel-Montpied [CHU Clermont-Ferrand]
Chaouat, Ari [Auteur]
Service de Pneumologie [CHRU Nancy]
Savale, Laurent [Auteur]
Université Paris-Saclay
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Jaïs, Xavier [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 [UP11]
Jevnikar, Mitja [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 - Faculté de médecine [UP11 UFR Médecine]
Traclet, Julie [Auteur]
Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie [Hôpital Louis Pradel]
De Groote, Pascal [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Simonneau, Gérald [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Hachulla, Éric [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Mouthon, Luc [Auteur]
Institut Cochin [IC UM3 (UMR 8104 / U1016)]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Montani, David [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
Humbert, Marc [Auteur]
Université Paris-Saclay
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Sitbon, Olivier [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 - Faculté de médecine [UP11 UFR Médecine]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Hôpital Bicêtre
Boucly, Athénaïs [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 - Faculté de médecine [UP11 UFR Médecine]
Launay, David [Auteur]

Service de médecine interne [Lille]
Lille Inflammation Research International Center - U 995 [LIRIC]
Cottin, Vincent [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Hôpital Louis Pradel [CHU - HCL]
Prévot, Grégoire [Auteur]
Service Pneumologie-Allergologie [CHU Toulouse]
Bourlier, Delphine [Auteur]
Dauphin, Claire [Auteur]
CHU Clermont-Ferrand
Service Médecine Interne - site Gabriel-Montpied [CHU Clermont-Ferrand]
Chaouat, Ari [Auteur]
Service de Pneumologie [CHRU Nancy]
Savale, Laurent [Auteur]
Université Paris-Saclay
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Jaïs, Xavier [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 [UP11]
Jevnikar, Mitja [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 - Faculté de médecine [UP11 UFR Médecine]
Traclet, Julie [Auteur]
Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie [Hôpital Louis Pradel]
De Groote, Pascal [Auteur]

Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Simonneau, Gérald [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Hachulla, Éric [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Mouthon, Luc [Auteur]
Institut Cochin [IC UM3 (UMR 8104 / U1016)]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Montani, David [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
Humbert, Marc [Auteur]
Université Paris-Saclay
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Sitbon, Olivier [Auteur]
Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique [HPPIT]
Université Paris-Sud - Paris 11 - Faculté de médecine [UP11 UFR Médecine]
Journal title :
European Respiratory Journal
Pages :
1800678
Publisher :
European Respiratory Society
Publication date :
2018-10-25
ISSN :
0903-1936
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
The prognostic importance of follow-up haemodynamics and the validity of multidimensional risk assessment are not well established for systemic sclerosis (SSc)-associated pulmonary arterial hypertension (PAH). We assessed ...
Show more >The prognostic importance of follow-up haemodynamics and the validity of multidimensional risk assessment are not well established for systemic sclerosis (SSc)-associated pulmonary arterial hypertension (PAH). We assessed incident SSc-PAH patients to determine the association between clinical and haemodynamic variables at baseline and first follow-up right heart catheterisation (RHC) with transplant-free survival. RHC variables included cardiac index, stroke volume index (SVI), pulmonary arterial compliance and pulmonary vascular resistance. Risk assessment was performed according to the number of low-risk criteria: functional class I or II, 6-min walking distance (6MWD) >440 m, right atrial pressure <8 mmHg and cardiac index ≥2.5 L·min −1 ·m −2 . Transplant-free survival from diagnosis (n=513) was 87%, 55% and 35% at 1, 3 and 5 years, respectively. At baseline, 6MWD was the only independent predictor. A follow-up RHC was available for 353 patients (median interval 4.6 months, interquartile range 3.9–6.4 months). The 6MWD, functional class, cardiac index, SVI, pulmonary arterial compliance and pulmonary vascular resistance were independently associated with transplant-free survival at follow-up, with SVI performing better than other haemodynamic variables. 1-year outcomes were better with increasing number of low-risk criteria at baseline (area under the curve (AUC) 0.63, 95% CI 0.56–0.69) and at first follow-up (AUC 0.71, 95% CI 0.64–0.78). Follow-up haemodynamics and multidimensional risk assessment had greater prognostic significance than at baseline in SSc-PAH.Show less >
Show more >The prognostic importance of follow-up haemodynamics and the validity of multidimensional risk assessment are not well established for systemic sclerosis (SSc)-associated pulmonary arterial hypertension (PAH). We assessed incident SSc-PAH patients to determine the association between clinical and haemodynamic variables at baseline and first follow-up right heart catheterisation (RHC) with transplant-free survival. RHC variables included cardiac index, stroke volume index (SVI), pulmonary arterial compliance and pulmonary vascular resistance. Risk assessment was performed according to the number of low-risk criteria: functional class I or II, 6-min walking distance (6MWD) >440 m, right atrial pressure <8 mmHg and cardiac index ≥2.5 L·min −1 ·m −2 . Transplant-free survival from diagnosis (n=513) was 87%, 55% and 35% at 1, 3 and 5 years, respectively. At baseline, 6MWD was the only independent predictor. A follow-up RHC was available for 353 patients (median interval 4.6 months, interquartile range 3.9–6.4 months). The 6MWD, functional class, cardiac index, SVI, pulmonary arterial compliance and pulmonary vascular resistance were independently associated with transplant-free survival at follow-up, with SVI performing better than other haemodynamic variables. 1-year outcomes were better with increasing number of low-risk criteria at baseline (area under the curve (AUC) 0.63, 95% CI 0.56–0.69) and at first follow-up (AUC 0.71, 95% CI 0.64–0.78). Follow-up haemodynamics and multidimensional risk assessment had greater prognostic significance than at baseline in SSc-PAH.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Collections :
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