TY - JOUR T1 - Unmasking hidden disease: exercise pulmonary haemodynamics in systemic sclerosis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00885-2017 VL - 50 IS - 1 SP - 1700885 AU - Robin Condliffe Y1 - 2017/07/01 UR - http://erj.ersjournals.com/content/50/1/1700885.abstract N2 - Although pulmonary arterial hypertension (PAH) is a rare condition in the general population, it is not uncommon in systemic sclerosis (SSc), with a prevalence of 9% [1]. Furthermore, survival in patients with PAH associated with SSc (SSc-PAH) is worse than in those with idiopathic PAH, even when accounting for their older age [2–4]. As a result, patients with SSc are the main “at-risk” patient group who undergo widespread screening for the presence of PAH. Patients identified with SSc-PAH as a result of screening appear to have less severe disease and better survival than those who are diagnosed following symptomatic presentation [5]. If PAH results from progressive loss of the pulmonary arterial bed, and over 50% of this vasculature needs to be obstructed before pulmonary hypertension (PH; as defined by a resting mean pulmonary arterial pressure (mPAP) ≥25 mmHg) develops, then there is a good rationale for the use of exercise to unmask hidden pulmonary vascular disease.Measuring pulmonary pressures on exercise in patients with systemic sclerosis may unmask pulmonary vascular disease http://ow.ly/EVZ330cyLNd ER -