Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 ESC/ERS definition of pulmonary hypertension and impact on mortality. Puigrenier, S., Giovannelli, J., Lamblin, N., De Groote, P., Fertin, M., Bervar, J., Lamer, A., Edmé, J., Balquet, M., Sobanski, V., Launay, D., Hachulla, É., & Sanges, S. Respiratory Research, 23(1):284, October, 2022. doi abstract bibtex BACKGROUND AND OBJECTIVE: The definition of pre-capillary pulmonary hypertension (PH) has been modified, with lowering of the mean pulmonary arterial pressure (mPAP) threshold from 25 to 20 mmHg and addition of a mandatory criterion of pulmonary vascular resistance (PVR) ≥ 2 Wood units (WU). Our objectives were: 1/ to estimate the proportion of patients reclassified as having pre-capillary PH when using the new 2022 ESC/ERS hemodynamic criteria (i.e. mPAP 21-24 mmHg and PVR ≥ 2 WU), and to describe their clinical characteristics and outcome; and 2/ to study the relationship between PVR and survival in patients with mPAP \textgreater 20 mmHg. METHODS: We retrospectively analyzed consecutive SSc patients included in our National Reference Center for a first right-heart catheterization between 2003 and 2018. The association between survival and PVR was studied using smoothing splines. RESULTS: We included 126 SSc patients with mPAP \textgreater 20 mmHg. Among them, 16 (13%) had a baseline mPAP value between 21 and 24 mmHg and PVR ≥ 2 mmHg and were reclassified as pre-capillary PH; 10 of which (62%) raised their mPAP ≥ 25 mmHg during follow-up. In patients with mPAP \textgreater 20 mmHg, we observed a linear relation between PVR and mortality for values \textless 6 WU. CONCLUSION: A significant proportion of SSc patients is reclassified as having pre-capillary PH with the new 2022 ESC/ERS hemodynamic definition. Lowering the PVR threshold from 3 to 2 WU captures patients at risk of raising their mPAP \textgreater 25 mmHg, with a possibly less severe disease.
@article{puigrenier_mild_2022,
title = {Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 {ESC}/{ERS} definition of pulmonary hypertension and impact on mortality},
volume = {23},
issn = {1465-993X},
shorttitle = {Mild pulmonary hemodynamic alterations in patients with systemic sclerosis},
doi = {10.1186/s12931-022-02205-4},
abstract = {BACKGROUND AND OBJECTIVE: The definition of pre-capillary pulmonary hypertension (PH) has been modified, with lowering of the mean pulmonary arterial pressure (mPAP) threshold from 25 to 20 mmHg and addition of a mandatory criterion of pulmonary vascular resistance (PVR) ≥ 2 Wood units (WU). Our objectives were: 1/ to estimate the proportion of patients reclassified as having pre-capillary PH when using the new 2022 ESC/ERS hemodynamic criteria (i.e. mPAP 21-24 mmHg and PVR ≥ 2 WU), and to describe their clinical characteristics and outcome; and 2/ to study the relationship between PVR and survival in patients with mPAP {\textgreater} 20 mmHg.
METHODS: We retrospectively analyzed consecutive SSc patients included in our National Reference Center for a first right-heart catheterization between 2003 and 2018. The association between survival and PVR was studied using smoothing splines.
RESULTS: We included 126 SSc patients with mPAP {\textgreater} 20 mmHg. Among them, 16 (13\%) had a baseline mPAP value between 21 and 24 mmHg and PVR ≥ 2 mmHg and were reclassified as pre-capillary PH; 10 of which (62\%) raised their mPAP ≥ 25 mmHg during follow-up. In patients with mPAP {\textgreater} 20 mmHg, we observed a linear relation between PVR and mortality for values {\textless} 6 WU.
CONCLUSION: A significant proportion of SSc patients is reclassified as having pre-capillary PH with the new 2022 ESC/ERS hemodynamic definition. Lowering the PVR threshold from 3 to 2 WU captures patients at risk of raising their mPAP {\textgreater} 25 mmHg, with a possibly less severe disease.},
language = {eng},
number = {1},
journal = {Respiratory Research},
author = {Puigrenier, Sébastien and Giovannelli, Jonathan and Lamblin, Nicolas and De Groote, Pascal and Fertin, Marie and Bervar, Jean-François and Lamer, Antoine and Edmé, Jean-Louis and Balquet, Marie-Hélène and Sobanski, Vincent and Launay, David and Hachulla, Éric and Sanges, Sébastien},
month = oct,
year = {2022},
pmid = {36243869},
pmcid = {PMC9571468},
keywords = {Diagnostic criteria, Hemodynamics, Humans, Hypertension, Pulmonary, Mortality, Pulmonary arterial hypertension, Pulmonary hypertension, Pulmonary vascular resistance, Retrospective Studies, Scleroderma, Systemic, Systemic sclerosis, Vascular Resistance},
pages = {284},
}
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{"_id":"YChHHttvWDoWJoPft","bibbaseid":"puigrenier-giovannelli-lamblin-degroote-fertin-bervar-lamer-edm-etal-mildpulmonaryhemodynamicalterationsinpatientswithsystemicsclerosisrelevanceofthenew2022escersdefinitionofpulmonaryhypertensionandimpactonmortality-2022","author_short":["Puigrenier, S.","Giovannelli, J.","Lamblin, N.","De Groote, P.","Fertin, M.","Bervar, J.","Lamer, A.","Edmé, J.","Balquet, M.","Sobanski, V.","Launay, D.","Hachulla, É.","Sanges, S."],"bibdata":{"bibtype":"article","type":"article","title":"Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 ESC/ERS definition of pulmonary hypertension and impact on mortality","volume":"23","issn":"1465-993X","shorttitle":"Mild pulmonary hemodynamic alterations in patients with systemic sclerosis","doi":"10.1186/s12931-022-02205-4","abstract":"BACKGROUND AND OBJECTIVE: The definition of pre-capillary pulmonary hypertension (PH) has been modified, with lowering of the mean pulmonary arterial pressure (mPAP) threshold from 25 to 20 mmHg and addition of a mandatory criterion of pulmonary vascular resistance (PVR) ≥ 2 Wood units (WU). Our objectives were: 1/ to estimate the proportion of patients reclassified as having pre-capillary PH when using the new 2022 ESC/ERS hemodynamic criteria (i.e. mPAP 21-24 mmHg and PVR ≥ 2 WU), and to describe their clinical characteristics and outcome; and 2/ to study the relationship between PVR and survival in patients with mPAP \\textgreater 20 mmHg. METHODS: We retrospectively analyzed consecutive SSc patients included in our National Reference Center for a first right-heart catheterization between 2003 and 2018. The association between survival and PVR was studied using smoothing splines. RESULTS: We included 126 SSc patients with mPAP \\textgreater 20 mmHg. Among them, 16 (13%) had a baseline mPAP value between 21 and 24 mmHg and PVR ≥ 2 mmHg and were reclassified as pre-capillary PH; 10 of which (62%) raised their mPAP ≥ 25 mmHg during follow-up. In patients with mPAP \\textgreater 20 mmHg, we observed a linear relation between PVR and mortality for values \\textless 6 WU. CONCLUSION: A significant proportion of SSc patients is reclassified as having pre-capillary PH with the new 2022 ESC/ERS hemodynamic definition. Lowering the PVR threshold from 3 to 2 WU captures patients at risk of raising their mPAP \\textgreater 25 mmHg, with a possibly less severe disease.","language":"eng","number":"1","journal":"Respiratory Research","author":[{"propositions":[],"lastnames":["Puigrenier"],"firstnames":["Sébastien"],"suffixes":[]},{"propositions":[],"lastnames":["Giovannelli"],"firstnames":["Jonathan"],"suffixes":[]},{"propositions":[],"lastnames":["Lamblin"],"firstnames":["Nicolas"],"suffixes":[]},{"propositions":[],"lastnames":["De","Groote"],"firstnames":["Pascal"],"suffixes":[]},{"propositions":[],"lastnames":["Fertin"],"firstnames":["Marie"],"suffixes":[]},{"propositions":[],"lastnames":["Bervar"],"firstnames":["Jean-François"],"suffixes":[]},{"propositions":[],"lastnames":["Lamer"],"firstnames":["Antoine"],"suffixes":[]},{"propositions":[],"lastnames":["Edmé"],"firstnames":["Jean-Louis"],"suffixes":[]},{"propositions":[],"lastnames":["Balquet"],"firstnames":["Marie-Hélène"],"suffixes":[]},{"propositions":[],"lastnames":["Sobanski"],"firstnames":["Vincent"],"suffixes":[]},{"propositions":[],"lastnames":["Launay"],"firstnames":["David"],"suffixes":[]},{"propositions":[],"lastnames":["Hachulla"],"firstnames":["Éric"],"suffixes":[]},{"propositions":[],"lastnames":["Sanges"],"firstnames":["Sébastien"],"suffixes":[]}],"month":"October","year":"2022","pmid":"36243869","pmcid":"PMC9571468","keywords":"Diagnostic criteria, Hemodynamics, Humans, Hypertension, Pulmonary, Mortality, Pulmonary arterial hypertension, Pulmonary hypertension, Pulmonary vascular resistance, Retrospective Studies, Scleroderma, Systemic, Systemic sclerosis, Vascular Resistance","pages":"284","bibtex":"@article{puigrenier_mild_2022,\n\ttitle = {Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 {ESC}/{ERS} definition of pulmonary hypertension and impact on mortality},\n\tvolume = {23},\n\tissn = {1465-993X},\n\tshorttitle = {Mild pulmonary hemodynamic alterations in patients with systemic sclerosis},\n\tdoi = {10.1186/s12931-022-02205-4},\n\tabstract = {BACKGROUND AND OBJECTIVE: The definition of pre-capillary pulmonary hypertension (PH) has been modified, with lowering of the mean pulmonary arterial pressure (mPAP) threshold from 25 to 20 mmHg and addition of a mandatory criterion of pulmonary vascular resistance (PVR) ≥ 2 Wood units (WU). Our objectives were: 1/ to estimate the proportion of patients reclassified as having pre-capillary PH when using the new 2022 ESC/ERS hemodynamic criteria (i.e. mPAP 21-24 mmHg and PVR ≥ 2 WU), and to describe their clinical characteristics and outcome; and 2/ to study the relationship between PVR and survival in patients with mPAP {\\textgreater} 20 mmHg.\nMETHODS: We retrospectively analyzed consecutive SSc patients included in our National Reference Center for a first right-heart catheterization between 2003 and 2018. The association between survival and PVR was studied using smoothing splines.\nRESULTS: We included 126 SSc patients with mPAP {\\textgreater} 20 mmHg. Among them, 16 (13\\%) had a baseline mPAP value between 21 and 24 mmHg and PVR ≥ 2 mmHg and were reclassified as pre-capillary PH; 10 of which (62\\%) raised their mPAP ≥ 25 mmHg during follow-up. In patients with mPAP {\\textgreater} 20 mmHg, we observed a linear relation between PVR and mortality for values {\\textless} 6 WU.\nCONCLUSION: A significant proportion of SSc patients is reclassified as having pre-capillary PH with the new 2022 ESC/ERS hemodynamic definition. Lowering the PVR threshold from 3 to 2 WU captures patients at risk of raising their mPAP {\\textgreater} 25 mmHg, with a possibly less severe disease.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Respiratory Research},\n\tauthor = {Puigrenier, Sébastien and Giovannelli, Jonathan and Lamblin, Nicolas and De Groote, Pascal and Fertin, Marie and Bervar, Jean-François and Lamer, Antoine and Edmé, Jean-Louis and Balquet, Marie-Hélène and Sobanski, Vincent and Launay, David and Hachulla, Éric and Sanges, Sébastien},\n\tmonth = oct,\n\tyear = {2022},\n\tpmid = {36243869},\n\tpmcid = {PMC9571468},\n\tkeywords = {Diagnostic criteria, Hemodynamics, Humans, Hypertension, Pulmonary, Mortality, Pulmonary arterial hypertension, Pulmonary hypertension, Pulmonary vascular resistance, Retrospective Studies, Scleroderma, Systemic, Systemic sclerosis, Vascular Resistance},\n\tpages = {284},\n}\n\n","author_short":["Puigrenier, S.","Giovannelli, J.","Lamblin, N.","De Groote, P.","Fertin, M.","Bervar, J.","Lamer, A.","Edmé, J.","Balquet, M.","Sobanski, V.","Launay, D.","Hachulla, É.","Sanges, S."],"key":"puigrenier_mild_2022","id":"puigrenier_mild_2022","bibbaseid":"puigrenier-giovannelli-lamblin-degroote-fertin-bervar-lamer-edm-etal-mildpulmonaryhemodynamicalterationsinpatientswithsystemicsclerosisrelevanceofthenew2022escersdefinitionofpulmonaryhypertensionandimpactonmortality-2022","role":"author","urls":{},"keyword":["Diagnostic criteria","Hemodynamics","Humans","Hypertension","Pulmonary","Mortality","Pulmonary arterial hypertension","Pulmonary hypertension","Pulmonary vascular resistance","Retrospective Studies","Scleroderma","Systemic","Systemic sclerosis","Vascular Resistance"],"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://api.zotero.org/users/1729868/collections/J5D9IHP7/items?key=n4LeME0A45w9AHGzM16k3I3O&format=bibtex&limit=100","dataSources":["9jtzjDGq8xfn9xiA9","EvCdEsC2AZvZsEKth","gPTiaacnxqbN8dgMR"],"keywords":["diagnostic criteria","hemodynamics","humans","hypertension","pulmonary","mortality","pulmonary arterial hypertension","pulmonary hypertension","pulmonary vascular resistance","retrospective studies","scleroderma","systemic","systemic sclerosis","vascular resistance"],"search_terms":["mild","pulmonary","hemodynamic","alterations","patients","systemic","sclerosis","relevance","new","2022","esc","ers","definition","pulmonary","hypertension","impact","mortality","puigrenier","giovannelli","lamblin","de groote","fertin","bervar","lamer","edmé","balquet","sobanski","launay","hachulla","sanges"],"title":"Mild pulmonary hemodynamic alterations in patients with systemic sclerosis: relevance of the new 2022 ESC/ERS definition of pulmonary hypertension and impact on mortality","year":2022}