HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 30/4/715    most recent 09031936.00107206v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Shorr, A. F. Articles by Nathan, S. D. Search for Related Content PubMed PubMed Citation Articles by Shorr, A. F. Articles by Nathan, S. D.

Pulmonary hypertension in patients with pulmonary fibrosis awaiting lung transplant

¹ Pulmonary and Critical Care Medicine Section, Washington Hospital Center, ³ Dept of Pulmonary and Critical Care Medicine, Walter Reed Army Medical Center, Washington, DC, ² United Network for Organ Sharing, Richmond, and ⁴ INOVA Transplant Center, Fairfax Inova Hospital, Falls Church, VA, USA.

CORRESPONDENCE: A. F. Shorr, Pulmonary and Critical Care Medicine Section, Washington Hospital Center, Room 2A-38D, 110 Irving St, NW, Washington DC 20010, USA. Fax: 1 2022910386. E-mail: afshorr{at}dnamail.com

Keywords: Epidemiology, haemodynamics, idiopathic pulmonary fibrosis, pulmonary hypertension

Received: August 16, 2006
Accepted June 25, 2007

Pulmonary hypertension (PH) may complicate idiopathic pulmonary fibrosis (IPF) but the prevalence of PH in IPF remains undefined. The present authors sought to describe the prevalence of PH in IPF.

The lung transplant registry for the USA (January 1995 to June 2004) was analysed and IPF patients who had undergone right heart catheterisation (RHC) were identified. PH was defined as a mean pulmonary arterial pressure (_pa) 25 mmHg and severe PH as a _pa >40 mmHg. Independent factors associated with PH were determined.

Of the 3,457 persons listed, 2,525 (73.0%) had undergone RHC. PH affected 46.1% of subjects; 9% had severe PH. Variables independently associated with mild-to-moderate PH were as follows: need for oxygen, pulmonary capillary wedge pressure (P_pcw) and forced expiratory volume in one second (FEV₁). Independent factors related to severe PH included the following: carbon dioxide tension, age, FEV₁, P_pcw, need for oxygen and ethnicity. A sensitivity analysis in subjects with P_pcw <15 mmHg did not appreciably alter the present findings.

Pulmonary hypertension is common in idiopathic pulmonary fibrosis patients awaiting lung transplant, but the elevations in mean pulmonary arterial pressure are moderate. Lung volumes alone do not explain the pulmonary hypertension. Given the prevalence of pulmonary hypertension and its relationship with surrogate markers for quality of life (e.g. activities of daily living), future trials of therapies for this may be warranted.

This article has been cited by other articles:

				T J Corte, S J Wort, M A Gatzoulis, P Macdonald, D M Hansell, and A U Wells Pulmonary vascular resistance predicts early mortality in patients with diffuse fibrotic lung disease and suspected pulmonary hypertension Thorax, October 1, 2009; 64(10): 883 - 888. [Abstract] [Full Text] [PDF]

				M. M. Hoeper, J. A. Barbera, R. N. Channick, P. M. Hassoun, I. M. Lang, A. Manes, F. J. Martinez, R. Naeije, H. Olschewski, J. Pepke-Zaba, et al. Diagnosis, assessment, and treatment of non-pulmonary arterial hypertension pulmonary hypertension. J. Am. Coll. Cardiol., June 30, 2009; 54(1 Suppl): S85 - S96. [Abstract] [Full Text] [PDF]

				A. Devaraj, A. U. Wells, M. G. Meister, T. J. Corte, and D. M. Hansell The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension Radiology, December 1, 2008; 249(3): 1042 - 1049. [Abstract] [Full Text] [PDF]

				J. Behr and J. H. Ryu Pulmonary hypertension in interstitial lung disease Eur. Respir. J., June 1, 2008; 31(6): 1357 - 1367. [Abstract] [Full Text] [PDF]