Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study
ABSTRACT Interstitial lung disease (ILD) can lead to pulmonary hypertension (ILD‐PH), worsening prognosis and increasing mortality. Diagnosing ILD‐PH is challenging due to the limitations of imaging methods. Right heart catheterization (RHC) is the gold standard for diagnosing PH but is limited to I...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Pulmonary Circulation |
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| Online Access: | https://doi.org/10.1002/pul2.70035 |
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| author | María Berenice Torres‐Rojas Dulce Iliana Navarro‐Vergara Marisol García‐Cesar Gustavo Acosta‐Altamirano Leslie Marisol González‐Hermosillo Galileo Escobedo Guillermo Cueto‐Robledo |
| author_facet | María Berenice Torres‐Rojas Dulce Iliana Navarro‐Vergara Marisol García‐Cesar Gustavo Acosta‐Altamirano Leslie Marisol González‐Hermosillo Galileo Escobedo Guillermo Cueto‐Robledo |
| author_sort | María Berenice Torres‐Rojas |
| collection | DOAJ |
| description | ABSTRACT Interstitial lung disease (ILD) can lead to pulmonary hypertension (ILD‐PH), worsening prognosis and increasing mortality. Diagnosing ILD‐PH is challenging due to the limitations of imaging methods. Right heart catheterization (RHC) is the gold standard for diagnosing PH but is limited to ILD patients considered for lung transplantation. This study assessed the usefulness of RHC in diagnosing ILD‐PH in a large cohort of 105 patients followed for at least 72 months, examining hemodynamic parameters for survival analysis. We conducted an ambispective cohort study, diagnosing PH as mean pulmonary artery pressure ≥ 20 mmHg, pulmonary arterial wedge pressure < 15 mmHg, and pulmonary vascular resistance > 2 Wood units by RHC. We registered demographic, biochemical, echocardiographic, respiratory, and hemodynamic parameters for survival analyses. Using RHC, we found a PH prevalence of 84.7% among ILD patients who previously exhibited an intermediate‐to‐high probability of PH by echocardiography. Thirty‐nine ILD‐PH patients died, yielding a 5‐year survival rate of 35%, whereas ILD patients without PH had a survival rate of 100%. Connective tissue disease‐associated ILD and interstitial pneumonia with autoimmune features were the predominant ILD subtypes in ILD‐PH patients. The ILD‐PH group had worse pulmonary function, lower forced vital capacity, and more severe hypoxemia. Kaplan–Meier analyses showed significantly lower survival rates in ILD‐PH patients with a 6‐min walking distance < 360 m, tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio < 0.35 mm/mmHg, venous oxygen saturation < 65%, and pulmonary artery compliance < 2.2 mm/mmHg. RHC accurately characterizes ILD‐PH and provides long‐term survival predictors. |
| format | Article |
| id | doaj-art-8d4be606c66744b987cdebc13f85ec5a |
| institution | OA Journals |
| issn | 2045-8940 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj-art-8d4be606c66744b987cdebc13f85ec5a2025-08-20T01:50:07ZengWileyPulmonary Circulation2045-89402025-01-01151n/an/a10.1002/pul2.70035Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort StudyMaría Berenice Torres‐Rojas0Dulce Iliana Navarro‐Vergara1Marisol García‐Cesar2Gustavo Acosta‐Altamirano3Leslie Marisol González‐Hermosillo4Galileo Escobedo5Guillermo Cueto‐Robledo6Cardiorespiratory Emergency Department General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoCardiorespiratory Emergency Department General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoCardiorespiratory Emergency Department General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoLaboratory of Immunometabolism, Research Division General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoCardiorespiratory Emergency Department General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoLaboratory of Immunometabolism, Research Division General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoCardiorespiratory Emergency Department General Hospital of Mexico “Dr. Eduardo Liceaga” Mexico City MexicoABSTRACT Interstitial lung disease (ILD) can lead to pulmonary hypertension (ILD‐PH), worsening prognosis and increasing mortality. Diagnosing ILD‐PH is challenging due to the limitations of imaging methods. Right heart catheterization (RHC) is the gold standard for diagnosing PH but is limited to ILD patients considered for lung transplantation. This study assessed the usefulness of RHC in diagnosing ILD‐PH in a large cohort of 105 patients followed for at least 72 months, examining hemodynamic parameters for survival analysis. We conducted an ambispective cohort study, diagnosing PH as mean pulmonary artery pressure ≥ 20 mmHg, pulmonary arterial wedge pressure < 15 mmHg, and pulmonary vascular resistance > 2 Wood units by RHC. We registered demographic, biochemical, echocardiographic, respiratory, and hemodynamic parameters for survival analyses. Using RHC, we found a PH prevalence of 84.7% among ILD patients who previously exhibited an intermediate‐to‐high probability of PH by echocardiography. Thirty‐nine ILD‐PH patients died, yielding a 5‐year survival rate of 35%, whereas ILD patients without PH had a survival rate of 100%. Connective tissue disease‐associated ILD and interstitial pneumonia with autoimmune features were the predominant ILD subtypes in ILD‐PH patients. The ILD‐PH group had worse pulmonary function, lower forced vital capacity, and more severe hypoxemia. Kaplan–Meier analyses showed significantly lower survival rates in ILD‐PH patients with a 6‐min walking distance < 360 m, tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio < 0.35 mm/mmHg, venous oxygen saturation < 65%, and pulmonary artery compliance < 2.2 mm/mmHg. RHC accurately characterizes ILD‐PH and provides long‐term survival predictors.https://doi.org/10.1002/pul2.70035forced vital capacityinterstitial lung diseasepulmonary artery compliancepulmonary hypertensionright heart catheterizationvenous oxygen saturation |
| spellingShingle | María Berenice Torres‐Rojas Dulce Iliana Navarro‐Vergara Marisol García‐Cesar Gustavo Acosta‐Altamirano Leslie Marisol González‐Hermosillo Galileo Escobedo Guillermo Cueto‐Robledo Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study Pulmonary Circulation forced vital capacity interstitial lung disease pulmonary artery compliance pulmonary hypertension right heart catheterization venous oxygen saturation |
| title | Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study |
| title_full | Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study |
| title_fullStr | Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study |
| title_full_unstemmed | Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study |
| title_short | Right Heart Catheterization Accurately Diagnoses Pulmonary Hypertension in Patients With Interstitial Lung Disease: Results From a Long‐Term Cohort Study |
| title_sort | right heart catheterization accurately diagnoses pulmonary hypertension in patients with interstitial lung disease results from a long term cohort study |
| topic | forced vital capacity interstitial lung disease pulmonary artery compliance pulmonary hypertension right heart catheterization venous oxygen saturation |
| url | https://doi.org/10.1002/pul2.70035 |
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