Clinical Predictors of Pulmonary Hypertension in Sarcoidosis

¹ Dept of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep, Wayne State University School of Medicine - Detroit Medical Center, Detroit, MI 48201, USA

^* To whom correspondence should be addressed. E-mail: lsamavat{at}med.wayne.edu.

	Abstract

Pulmonary hypertension (PH) adversely affects outcome in sarcoidosis and is an important predictor of mortality in these patients. Early and accurate diagnosis of this complication may improve outcome. We hypothesized that integration of six-minute walk test (6MWT) as part of the evaluation leads to an earlier diagnosis of this complication.

162 patients with sarcoidosis underwent 6MWT. We analyzed demographic and pulmonary function results. Patients were further assessed by echocardiography and right heart catheterization when clinically indicated.

Patients with sarcoidosis-associated PH had significantly lower levels on pulmonary function tests. They also walked shorter distances and desaturated to lower levels on 6MWT. On logistic regression analyses, significant predictors of PH were oxygen saturation <90% on 6MWT (OR=12.1; p<0.001, 95% CI) and DL_CO<60% predicted (OR=7.3; p=0.03, 95% CI). Moreover, by combining the results of oxygen saturation at six-minutes with those of echocardiography, the ability to correctly predict the presence of PH by right heart catheterization was improved.

Patients with DL_CO less than 60% predicted and oxygen desaturation below 90% on 6MWT have a high likelihood of PH and should undergo further evaluation for the presence of this disorder.