PT  - JOURNAL ARTICLE
AU  - Bruno Degano
AU  - Thibaud Soumagne
AU  - Thomas Delaye
AU  - Patrick Berger
AU  - Thierry Perez
AU  - Alicia Guillien
AU  - Jean-Luc Pellegrin
AU  - David Launay
AU  - Nadine Magy-Bertrand
AU  - Christian Agard
AU  - Kiet Phong Tiev
AU  - Thông Hua-Huy
AU  - Catherine Tardiff
AU  - Véronique Diaz
AU  - Arnaud Chambellan
AU  - Anh Tuan Dinh-Xuan
TI  - Combined measurement of carbon monoxide and nitric oxide lung transfer does not improve the identification of pulmonary hypertension in systemic sclerosis
AID  - 10.1183/13993003.01008-2017
DP  - 2017 Oct 01
TA  - European Respiratory Journal
PG  - 1701008
VI  - 50
IP  - 4
4099  - http://erj.ersjournals.com/content/50/4/1701008.short
4100  - http://erj.ersjournals.com/content/50/4/1701008.full
SO  - Eur Respir J2017 Oct 01; 50
AB  - Screening is important to determine whether patients with systemic sclerosis (SSc) have pulmonary hypertension because earlier pulmonary hypertension treatment can improve survival in these patients. Although decreased transfer factor of the lung for carbon monoxide (TLCO) is currently considered the best pulmonary function test for screening for pulmonary hypertension in SSc, small series have suggested that partitioning TLCO into membrane conductance (diffusing capacity) for carbon monoxide (DMCO) and alveolar capillary blood volume (VC) through combined measurement of TLCO and transfer factor of the lung for nitric oxide (TLNO) is more effective to identify pulmonary hypertension in SSc patients compared with TLCO alone. Here, the objective was to determine whether combined TLCO–TLNO partitioned with recently refined equations could more accurately detect pulmonary hypertension than TLCO alone in SSc.For that purpose, 572 unselected consecutive SSc patients were retrospectively recruited in seven French centres.Pulmonary hypertension was diagnosed with right heart catheterisation in 58 patients. TLCO, TLNO and VC were all lower in SSc patients with pulmonary hypertension than in SSc patients without pulmonary hypertension. The area under the receiver operating characteristic curve for the presence of pulmonary hypertension was equivalent for TLCO (0.82, 95% CI 0.79–0.85) and TLNO (0.80, 95% CI 0.76–0.83), but lower for VC (0.75, 95% CI 0.71–0.78) and DMCO (0.66, 95% CI 0.62–0.70).Compared with TLCO alone, combined TLCO–TLNO does not add capability to detect pulmonary hypertension in unselected SSc patients.Compared with T LCO alone, combined T LCO–T LNO measurement does not improve detection of PH in unselected SSc patients http://ow.ly/ITHO30eldMk