Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study
Introduction: Diffuse Parenchymal Lung Disease (DPLD) comprise a heterogeneous group of diseases that occur when an abnormal healing response is induced by injury to the lungs. The diagnosis of DPLD is based on clinical presentation and radiological features. The initial diagnostic work-up includes...
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JCDR Research and Publications Private Limited
2025-03-01
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| author | Anubhab Moulik Jaydip Deb Sourindra Nath Banerjee Priyanka Ray Pulak Kumar Jana Sukanta Kodali Saswata Ghosh |
| author_facet | Anubhab Moulik Jaydip Deb Sourindra Nath Banerjee Priyanka Ray Pulak Kumar Jana Sukanta Kodali Saswata Ghosh |
| author_sort | Anubhab Moulik |
| collection | DOAJ |
| description | Introduction: Diffuse Parenchymal Lung Disease (DPLD) comprise a heterogeneous group of diseases that occur when an abnormal healing response is induced by injury to the lungs. The diagnosis of DPLD is based on clinical presentation and radiological features. The initial diagnostic work-up includes Pulmonary Function Tests (PFT), such as spirometry and diffusion tests.
Aim: To evaluate the accuracy of the Forced Vital Capacity/Diffusion Capacity of Lung for Carbon Monoxide (FVC/DLCO) ratio in predicting the presence of pulmonary hypertension in patients with DPLD.
Materials and Methods: A cross-sectional study was conducted from January 2023 to March 2024 in the Inpatient Department (IPD) and Outpatient Department (OPD) of Nilratan Sircar (NRS) Medical College and Hospital, Kolkata, West Bengal, India. A total of 50 patients underwent High-Resolution Computed Tomography (HRCT) thorax and spirometry with DLCO, along with some other ancillary investigations. The parameters evaluated primarily include a descriptive account of the spirometry values, which were Forced Expiratory Volume in 1 second (FEV1), FVC and DLCO, as well as the 6-Minute Walk Distance (6MWD) for physiological assessment and ECHO 2D for the evaluation of pulmonary hypertension. Simple logistic regression was performed between the FVC/DLCO ratio and the presence or absence of pulmonary hypertension based on ECHO 2D with Doppler as the binary outcome. The Receiver Operating Characteristic (ROC) curve was obtained and the FVC/DLCO cut-off ratio was adjusted to achieve the highest sensitivity for predicting pulmonary hypertension based on this dataset.
Results: Out of 50 patients (30 females and 20 males), the most common HRCT thorax pattern was Usual Interstitial Pneumonia (UIP), observed in 19 patients (38%), followed by Non Specific Interstitial Pneumonia (NSIP) in 11 patients (22%). The single most common DPLD was Idiopathic Pulmonary Fibrosis (IPF), with 11 patients (22%), while the most common group was Connective Tissue Disease-related DPLD (CTD-DPLD), comprising 22 patients (44%). An FVC/DLCO ratio of 0.97 was found to have a sensitivity of 81%, specificity of 77%, a Positive Predictive Value (PPV) of 86%, a Negative Predictive Value (NPV) of 70% and a diagnostic accuracy of 80% in predicting pulmonary hypertension.
Conclusion: The FVC/DLCO ratio of 0.97 represents a modality that could aid in the diagnosis of pulmonary hypertension. |
| format | Article |
| id | doaj-art-53904f8c27074b2a9277d2437e3f7ffc |
| institution | DOAJ |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-53904f8c27074b2a9277d2437e3f7ffc2025-08-20T03:08:37ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-03-01193010410.7860/JCDR/2025/76367.20689Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional StudyAnubhab Moulik0Jaydip Deb1Sourindra Nath Banerjee2Priyanka Ray3Pulak Kumar Jana4Sukanta Kodali5Saswata Ghosh6Postgraduate Trainee, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Professor and Head, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Associate Professor, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Assistant Professor, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Professor, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Assistant Professor, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Associate Professor, Department of Respiratory Medicine, Nilratan Sircar Medical College, Kolkata, West Bengal, India.Introduction: Diffuse Parenchymal Lung Disease (DPLD) comprise a heterogeneous group of diseases that occur when an abnormal healing response is induced by injury to the lungs. The diagnosis of DPLD is based on clinical presentation and radiological features. The initial diagnostic work-up includes Pulmonary Function Tests (PFT), such as spirometry and diffusion tests. Aim: To evaluate the accuracy of the Forced Vital Capacity/Diffusion Capacity of Lung for Carbon Monoxide (FVC/DLCO) ratio in predicting the presence of pulmonary hypertension in patients with DPLD. Materials and Methods: A cross-sectional study was conducted from January 2023 to March 2024 in the Inpatient Department (IPD) and Outpatient Department (OPD) of Nilratan Sircar (NRS) Medical College and Hospital, Kolkata, West Bengal, India. A total of 50 patients underwent High-Resolution Computed Tomography (HRCT) thorax and spirometry with DLCO, along with some other ancillary investigations. The parameters evaluated primarily include a descriptive account of the spirometry values, which were Forced Expiratory Volume in 1 second (FEV1), FVC and DLCO, as well as the 6-Minute Walk Distance (6MWD) for physiological assessment and ECHO 2D for the evaluation of pulmonary hypertension. Simple logistic regression was performed between the FVC/DLCO ratio and the presence or absence of pulmonary hypertension based on ECHO 2D with Doppler as the binary outcome. The Receiver Operating Characteristic (ROC) curve was obtained and the FVC/DLCO cut-off ratio was adjusted to achieve the highest sensitivity for predicting pulmonary hypertension based on this dataset. Results: Out of 50 patients (30 females and 20 males), the most common HRCT thorax pattern was Usual Interstitial Pneumonia (UIP), observed in 19 patients (38%), followed by Non Specific Interstitial Pneumonia (NSIP) in 11 patients (22%). The single most common DPLD was Idiopathic Pulmonary Fibrosis (IPF), with 11 patients (22%), while the most common group was Connective Tissue Disease-related DPLD (CTD-DPLD), comprising 22 patients (44%). An FVC/DLCO ratio of 0.97 was found to have a sensitivity of 81%, specificity of 77%, a Positive Predictive Value (PPV) of 86%, a Negative Predictive Value (NPV) of 70% and a diagnostic accuracy of 80% in predicting pulmonary hypertension. Conclusion: The FVC/DLCO ratio of 0.97 represents a modality that could aid in the diagnosis of pulmonary hypertension.https://jcdr.net/articles/PDF/20689/76367_CE[Ra1]_F(SS)_QC(PS_SL)_PF1(AG_OM)_redo_PFA(IS)_PB(AG_IS)_PN(IS).pdfidiopathic pulmonary fibrosissystemic sclerosisusual interstitial pneumonia |
| spellingShingle | Anubhab Moulik Jaydip Deb Sourindra Nath Banerjee Priyanka Ray Pulak Kumar Jana Sukanta Kodali Saswata Ghosh Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study Journal of Clinical and Diagnostic Research idiopathic pulmonary fibrosis systemic sclerosis usual interstitial pneumonia |
| title | Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study |
| title_full | Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study |
| title_fullStr | Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study |
| title_full_unstemmed | Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study |
| title_short | Prediction of Pulmonary Hypertension in Patients with Diffuse Parenchymal Lung Disease using Forced Vital Capacity/ Diffusion Capacity of Lung using Carbon Monoxide Ratio: A Cross-sectional Study |
| title_sort | prediction of pulmonary hypertension in patients with diffuse parenchymal lung disease using forced vital capacity diffusion capacity of lung using carbon monoxide ratio a cross sectional study |
| topic | idiopathic pulmonary fibrosis systemic sclerosis usual interstitial pneumonia |
| url | https://jcdr.net/articles/PDF/20689/76367_CE[Ra1]_F(SS)_QC(PS_SL)_PF1(AG_OM)_redo_PFA(IS)_PB(AG_IS)_PN(IS).pdf |
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