Pneumologie 2018; 72(S 01): S7
DOI: 10.1055/s-0037-1619134
Sektion 6 – Kardiorespiratorische Interaktion
Freie Vorträge – Titel: Kardiale Funktion bei pneumologischen Patienten, neue Messmethoden und Frühdiagnostik
Georg Thieme Verlag KG Stuttgart · New York

Patients with systemic sclerosis and borderline pulmonary arterial pressures display reduced right ventricular contractile reserve

B Egenlauf
1   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg
,
A Marra
1   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg
,
C Nagel
1   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg
,
S Harutyunova
1   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg
,
HM Lorenz
2   Department of Rheumatology, University Hospital Heidelberg
,
N Blank
2   Department of Rheumatology, University Hospital Heidelberg
,
C Fiehn
3   Praxis für Rheumatologie und Klinische Immunologie, Baden-Baden
,
E Hadaschik
4   Department of Dermatology, University of Heidelberg
,
N Benjamin
1   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg
,
C Fischer
5   Institute of Human Genetics, University of Heidelberg
,
E Grünig
1   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg
› Author Affiliations
Further Information

Publication History

Publication Date:
21 February 2018 (online)

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Background:

Borderline pulmonary arterial pressures (BoPAP) in patients with systemic sclerosis (SSc) are a frequent finding and could represent an intermediate stage between normal pulmonary pressures and manifest pulmonary hypertension (PH).

Objectives:

To characterize the difference in right ventricular response to exercise between SSc patients with normal hemodynamics and BoPAP-patients.

Methods:

Patients with confirmed SSc (n = 112) underwent right heart catheterization (RHC) at rest and during exercise and were divided into three groups according to their resting mean pulmonary artery pressure (mPAP) values: normal (mPAp ≤20 mmHg), BoPAP (mPAP 21 – 24 mmHg) and manifest PH (mPAp ≥25 mmHg).

Results:

SSc patients with BoPAP showed significantly lower right ventricular contractile reserve than SSc patients with normal hemodynamics as shown by reduced cardiac output (CO) and cardiac index (CI) increase during exercise measured by RHC (Δ CO: 5.76 ± 2.56 l/min vs. 3.51 ± 2.50, p < 0.003; Δ CI: 3.31 ± 1.52 vs. 2.11 ± 1.18 l/min/m2, p < 0.006).

Conclusion:

SSc patients with BoPAP already displayed a reduced right ventricular contractile reserve together with elevated pulmonary vascular resistance and transpulmonary gradient and reduced exercise capacity compared with SSc patients and normal resting hemodynamics. This lends support to BoPAP being an early stage of pulmonary vascular disease.