TY -的T1 -识别早期肺部动脉l hypertension in patients with systemic sclerosis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00495-2018 VL - 51 IS - 4 SP - 1800495 AU - Condliffe, Robin AU - Kovacs, Gabor Y1 - 2018/04/01 UR - //www.qdcxjkg.com/content/51/4/1800495.abstract N2 - Pulmonary arterial hypertension (PAH) is a life-shortening complication of systemic sclerosis (SSc) with a life-time prevalence of approximately 10% [1, 2]. It is currently defined by the presence of a mean pulmonary arterial pressure (mPAP) ≥25 mmHg with a pulmonary arterial wedge pressure (PAWP) ≤15 mmHg and a pulmonary vascular resistance (PVR) >3 WU, in the absence of significant lung disease or chronic thromboembolic disease. Other forms of pulmonary hypertension (PH) may also quite commonly exist in SSc patients, including PH due to left heart disease or lung disease. It is widely agreed that identifying patients with SSc who also have PAH (SSc-PAH) earlier in their disease process is likely a good idea with the presumption that earlier diagnosis leads to earlier treatment, which hopefully leads to better outcomes. Certainly, previous data have demonstrated superior survival in patients with SSc-PAH identified by screening when compared with patients presenting due to symptoms [3]. Over the past few years several groups have investigated the optimal way of screening SSc patients for the presence of PAH, most notably the DETECT investigators [4]. The DETECT study demonstrated that in a population of SSc patients enriched for the likely presence of PAH (by including patients only with a diffusion coefficient for carbon monoxide, DLCO, <60% predicted), a two-step algorithm including electrocardiographic, echocardiographic and laboratory biomarkers selecting patients to undergo right heart catheterisation (RHC) had greater sensitivity than echocardiography alone in identifying patients with PH. Superiority in clinical practice in non-enriched populations of SSc patients when compared to approaches combining echocardiography, trends in DLCO and clinical history has not been clearly demonstrated [5]. Nevertheless, the DETECT algorithm has been a welcome introduction in stimulating efforts to identify SSc-PAH patients at an earlier stage.New data to help earlier identification of patients with pulmonary arterial hypertension associated with systemic sclerosis http://ow.ly/lwsC30j2055 ER -