A scoring system to predict the elevation of mean pulmonary arterial pressure in idiopathic pulmonary fibrosis

Taiki Furukawa, Yasuhiro Kondoh, Hiroyuki Taniguchi, Mitsuaki Yagi, Toshiaki Matsuda, Tomoki Kimura, Kensuke Kataoka, Takeshi Johkoh, Masahiko Ando, Naozumi Hashimoto, Koji Sakamoto, Yoshinori Hasegawa

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26 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article number1701311
JournalEuropean Respiratory Journal
Volume51
Issue number1
DOIs
Publication statusPublished - 2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

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