Elevated Pulmonary Arterial Systolic Pressure in Patients with Sarcoidosis: Prevalence and Risk Factors

Rapti, Aggeliki; Kouranos, Vasilis; Gialafos, Elias; Aggeli, Konstantina; Moyssakis, John; Kallianos, Anastasios; Kostopoulos, Charalampos; Anagnostopoulou, Ourania; Sfikakis, Petros P.; Wells, Athol U.; Tzelepis, George E.

doi:10.1007/s00408-012-9442-4

Cited by 36 publications

(39 citation statements)

References 29 publications

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“…This apparent disconnect is thought to be accounted for by pulmonary artery remodelling accompanying the parenchymal disease [2,9,13,14]. In contrast, the prevalence and severity of pulmonary hypertension in several types of ILD, such as IPF [23,24,34,35], scleroderma [27,36,37] and sarcoidosis [23,28,38], correlate significantly with low diffusing capacity of the lung for carbon monoxide (especially with values <40% of predicted) reflecting perfusion impairment.…”

Section: The Pulmonary Circulationmentioning

confidence: 99%

“…When clinically manifested, direct cardiac involvement in systemic sclerosis is of adverse prognostic significance [49]. Patients with sarcoidosis are also at risk of direct myocardial involvement that may result in left ventricular dysfunction [38]. In a retrospective analysis of 363 patients with sarcoidosis listed for lung transplantation, resting pulmonary capillary wedge pressure was concomitantly higher in the setting of pulmonary hypertension (n=268); however, it remained within the normal range (<15 mmHg) even in the subset of patients with severe pulmonary hypertension (n=131) [28].…”

Section: The Left Heartmentioning

confidence: 99%

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Pulmonary vascular and cardiac impairment in interstitial lung disease

et al. 2017

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@ERSpublications Development of pulmonary hypertension is a major adverse factor in the natural history of interstitial lung disease http://ow.ly/nJB0302XAmD ABSTRACT Pulmonary vascular and cardiac impairment is increasingly appreciated as a major adverse factor in the natural history of interstitial lung disease. This clinically orientated review focuses on the current concepts in the pathogenesis, pathophysiology and implications of the detrimental sequence of increased pulmonary vascular resistance, pre-capillary pulmonary hypertension and right heart failure in interstitial lung disease, and provides guidance on its management.

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Section: The Pulmonary Circulationmentioning

confidence: 99%

Section: The Left Heartmentioning

confidence: 99%

Pulmonary vascular and cardiac impairment in interstitial lung disease

et al. 2017

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“…However, dyspnoea from cardiac disease may also result from left ventricular diastolic dysfunction due to age or arterial hypertension, or PH, even in the absence of pulmonary fibrosis [98]. Arrhythmias are a common manifestation: sarcoidosis may present with complete heart block or sudden death.…”

Section: Cardiac Diseasementioning

confidence: 99%

“…Advanced imaging also offers advantages in prognostic evaluation. Apart from identifying severe left ventricular dysfunction, in itself a malignant prognostic determinant [98], CMR [101] or FDG-PET [102][103][104] evidence of active disease is strongly predictive of future death or ventricular tachycardia. The first-line treatment of cardiac sarcoidosis is high-dose corticosteroid therapy, which tends to be more efficacious in patients with atrioventricular conduction disease or mild-to-moderate left ventricular dysfunction than in severe left ventricular dysfunction [105].…”

Section: Cardiac Diseasementioning

confidence: 99%

Comorbidities in interstitial lung diseases

2017

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Fibrosing lung disorders include a large number of diseases with diverse behaviour. Patients can die because of the progression of their illness, remain stable or even improve after appropriate treatment has been instituted. Comorbidities, such as acute and chronic infection, gastro-oesophageal reflux, pulmonary hypertension, lung cancer, cardiovascular diseases, and obstructive sleep apnoea, can pre-exist or develop at any time during the course of the disease and, if unidentified and untreated, may impair quality of life, impact upon the respiratory status of the patients, and ultimately lead to disease progression and death. Therefore, early identification and accurate treatment of comorbidities is essential.

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“…In a previous Japanese study, PH was found to be present in 5.7% of cases of CS 1 20. In another study, sarcoidosis-related PH was found to be approximately 12% by Doppler echocardiography 21. PH can be the result of decreased output due to poor left ventricular function or it can be seen in patients with PS with hypoxic vasoconstriction 1 2.…”

Section: Discussionmentioning

confidence: 94%

Assessment of Right Ventricular Systolic and Diastolic Parameters in Pulmonary Sarcoidosis

İpek

Demirelli

Ermis

et al. 2016

Journal of Investigative Medicine

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The clinical manifestations of cardiac involvement are seen in about 5% of patients with sarcoidosis; however, the incidence of cardiac involvement is higher in the autopsy series. About 14% of patients with pulmonary sarcoidosis (PS) without known cardiac involvement had diastolic dysfunction.We aimed to determine the role of parameters of right ventricular (RV) systolic and diastolic function in patients with PS without evidence of cardiac symptoms. Our study population consisted of 28 patients with grades 1-4 PS and 24 healthy subjects. This study was a clinical prospective cohort study. RV end-diastolic area was found to be significantly higher in the PS group (p=0.032). RV fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE) were shown to be statistically lower in the PS group as compared to the control group (p<0.001). However, pulmonary arterial systolic pressure was significantly higher in the PS group (p=0.003). The tricuspid E velocity and E/A ratio were found to be significantly lower in the PS group (p=0.025 and 0.009, respectively), while the tricuspid A velocity and myocardial performance index (MPI) were found to be significantly lower in the control group (p=0.034 and 0.007, respectively). Early detection of cardiac involvement in PS is crucial because of the increased morbidity and risk of sudden cardiac death. RV diastolic Doppler parameters, tissue Doppler MPI, RVFAC and TAPSE are practical and cheap techniques in the diagnosis of cardiac involvement in patients with PS. A thorough transthorasic echocardiographic examination including RV systolic and diastolic functions and tissue Doppler MPI should constitute the mainstay of initial management and follow-up in PS.

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Elevated Pulmonary Arterial Systolic Pressure in Patients with Sarcoidosis: Prevalence and Risk Factors

Abstract: In a large cohort of sarcoidosis patients, this study found a prevalence of SRPH of about 12 %. Pulmonary fibrosis and left ventricular diastolic dysfunction due to cardiac sarcoidosis or other comorbidities are frequent pathogenic mechanisms.

Cited by 36 publications

References 29 publications

Pulmonary vascular and cardiac impairment in interstitial lung disease

Pulmonary vascular and cardiac impairment in interstitial lung disease

Comorbidities in interstitial lung diseases

Assessment of Right Ventricular Systolic and Diastolic Parameters in Pulmonary Sarcoidosis

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