Pulmonary haemodynamics at rest and during exercise was studied in 30 patients with histologically confirmed sarcoidosis. All subjects were divided into three groups according to the stage of the disease assessed by radiological image of pulmonary lesions. At rest, in stage I and II patients, the mean pulmonary pressure (PAP) was normal. In stage IIIpatients, a slight pulmonary hypertension was found. During exercise, a rise in Pap in stage I and II subjects was within the normal limits for a given workload, although in individual stage IIsubjects a rise in PAP was abnormally high. In all stage IIIpatients a rise in Pap was pathologically elevated
Effects of 12 months steroid treatment on pulmonary haemodynamics in 24 patients with pulmonary sarcoidosis, stage II and III, were investigated. All patients had a chest radiograph, lung function tests, and pulmonary haemodynamics (measured at rest and during submaximal exercise) prior to the treatment. Resting pulmonary hypertension was found in 3 patients. In 18 an abnormal increase in pulmonary arterial mean pressure (PAP) on exercise was observed. All investigations were repeated after a year of treatment. In almost all patients (22) a regression of radiological changes in the lungs and improvement of pulmonary function were observed. The changes in pulmonary circulation were less uniform. In only half of the patients studied was regression of the disease seen on chest X-ray and improvement in lung function accompanied by improvement in pulmonary haemodynamics.
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