TY - JOUR
T1 - A scoring system to predict the elevation of mean pulmonary arterial pressure in idiopathic pulmonary fibrosis
AU - Furukawa, Taiki
AU - Kondoh, Yasuhiro
AU - Taniguchi, Hiroyuki
AU - Yagi, Mitsuaki
AU - Matsuda, Toshiaki
AU - Kimura, Tomoki
AU - Kataoka, Kensuke
AU - Johkoh, Takeshi
AU - Ando, Masahiko
AU - Hashimoto, Naozumi
AU - Sakamoto, Koji
AU - Hasegawa, Yoshinori
N1 - Publisher Copyright:
Copyright ©ERS 2018
PY - 2018
Y1 - 2018
N2 - Elevated mean pulmonary arterial pressure (MPAP; 21 mmHg) is sometimes seen in patients with idiopathic pulmonary fibrosis (IPF) and has an adverse impact upon survival. Although early diagnosis is crucial, there is no established screening tool that uses a combination of noninvasive examinations. We retrospectively analysed IPF patients at initial evaluation from April 2007 to July 2015 and, using logistic regression analysis, created a screening tool to identify elevated MPAP. Internal validation was also assessed for external validity using a bootstrap method. Using right-heart catheterisation (RHC), elevation of MPAP was determined to be present in 55 out of 273 patients. Multivariate models demonstrated that % predicted diffusing capacity of the lung for carbon monoxide (DLCO) <50%, ratio of pulmonary artery diameter to aorta diameter (PA/Ao) on computed tomography (CT) 0.9 and arterial oxygen tension (PaO2) <80 Torr were independent predictors. When we assigned a single point to each variable, the prevalence of elevation of MPAP with a score of zero, one, two or three points was 6.7%, 16.0%, 29.1% and 65.4%, respectively. The area under curve (AUC) for the receiver operating characteristic (ROC) curve was good at 0.757 (95% CI 0.682–0.833). A simple clinical scoring system consisting of % predicted DLCO, PA/Ao ratio on CT and PaO2 can easily predict elevation of MPAP in patients with IPF.
AB - Elevated mean pulmonary arterial pressure (MPAP; 21 mmHg) is sometimes seen in patients with idiopathic pulmonary fibrosis (IPF) and has an adverse impact upon survival. Although early diagnosis is crucial, there is no established screening tool that uses a combination of noninvasive examinations. We retrospectively analysed IPF patients at initial evaluation from April 2007 to July 2015 and, using logistic regression analysis, created a screening tool to identify elevated MPAP. Internal validation was also assessed for external validity using a bootstrap method. Using right-heart catheterisation (RHC), elevation of MPAP was determined to be present in 55 out of 273 patients. Multivariate models demonstrated that % predicted diffusing capacity of the lung for carbon monoxide (DLCO) <50%, ratio of pulmonary artery diameter to aorta diameter (PA/Ao) on computed tomography (CT) 0.9 and arterial oxygen tension (PaO2) <80 Torr were independent predictors. When we assigned a single point to each variable, the prevalence of elevation of MPAP with a score of zero, one, two or three points was 6.7%, 16.0%, 29.1% and 65.4%, respectively. The area under curve (AUC) for the receiver operating characteristic (ROC) curve was good at 0.757 (95% CI 0.682–0.833). A simple clinical scoring system consisting of % predicted DLCO, PA/Ao ratio on CT and PaO2 can easily predict elevation of MPAP in patients with IPF.
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U2 - 10.1183/13993003.01311-2017
DO - 10.1183/13993003.01311-2017
M3 - Article
C2 - 29348178
AN - SCOPUS:85057548341
SN - 0903-1936
VL - 51
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 1
M1 - 1701311
ER -