Pulmonary Hypertension in Systemic Lupus Erythematosus
Pulmonary Hypertension in Systemic Lupus Erythematosus
One hundred twenty-two patients with SLE consecutively admitted to the Rheumatology Out Patient Clinic of Hacettepe University Hospital during a 6-month period and who fulfilled the American College of Rheumatology classification criteria for SLE were enrolled into the study. Medical records of the patients were reviewed retrospectively. Demographic characteristics, clinical features, and laboratory results (antinuclear antibodies, anti-dsDNA antibodies, anticardiolipin antibodies, lupus anticoagulants) of the patients were recorded.
Patients who had a systolic pulmonary arterial pressure (sPAP) of 40 mm Hg or greater by Doppler echocardiography (sPAP = 4 × tricuspid regurgitant jet velocity + estimated right atrial pressure) were considered to have PH. If performed, right heart catheterization (RHC) results were noted. To determine the cause of PH in these patients, additional imaging and laboratory results that are useful for determining the accurate cause of PH such as lung computed tomography, ventilation/perfusion lung scanning, lung function tests, and thyroid function tests were reassessed from their medical records on top of echocardiographic examination and RHC results. Causes of PH were classified according to current guidelines. Any surgical and medical intervention histories of these patients with SLE with PH were also investigated.
Renal involvement was defined as the presence of urinary cellular casts and/or more than 500 mg/d protein loss and serositis as the presence of pleural and/or pericardial effusion unless related to other causes than SLE. Pulmonary parenchymal involvement was defined as the presence of interstitial lung disease or lupus pneumonitis or pulmonary hemorrhage (according to high-resolution computed tomography findings). The study was approved by the local ethics committee of Hacettepe University.
For statistical comparison of clinical and laboratory features, χ test and Mann-Whitney U tests were used. Values are expressed as the mean ± SD. Results were considered significant when P < 0.05.
Patients and Methods
One hundred twenty-two patients with SLE consecutively admitted to the Rheumatology Out Patient Clinic of Hacettepe University Hospital during a 6-month period and who fulfilled the American College of Rheumatology classification criteria for SLE were enrolled into the study. Medical records of the patients were reviewed retrospectively. Demographic characteristics, clinical features, and laboratory results (antinuclear antibodies, anti-dsDNA antibodies, anticardiolipin antibodies, lupus anticoagulants) of the patients were recorded.
Patients who had a systolic pulmonary arterial pressure (sPAP) of 40 mm Hg or greater by Doppler echocardiography (sPAP = 4 × tricuspid regurgitant jet velocity + estimated right atrial pressure) were considered to have PH. If performed, right heart catheterization (RHC) results were noted. To determine the cause of PH in these patients, additional imaging and laboratory results that are useful for determining the accurate cause of PH such as lung computed tomography, ventilation/perfusion lung scanning, lung function tests, and thyroid function tests were reassessed from their medical records on top of echocardiographic examination and RHC results. Causes of PH were classified according to current guidelines. Any surgical and medical intervention histories of these patients with SLE with PH were also investigated.
Renal involvement was defined as the presence of urinary cellular casts and/or more than 500 mg/d protein loss and serositis as the presence of pleural and/or pericardial effusion unless related to other causes than SLE. Pulmonary parenchymal involvement was defined as the presence of interstitial lung disease or lupus pneumonitis or pulmonary hemorrhage (according to high-resolution computed tomography findings). The study was approved by the local ethics committee of Hacettepe University.
Statistical Analysis
For statistical comparison of clinical and laboratory features, χ test and Mann-Whitney U tests were used. Values are expressed as the mean ± SD. Results were considered significant when P < 0.05.
