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Prevalence and risk factors for pulmonary arterial hypertension in patients with lupus

Prabu, Athiveeraramapandian (2013)
M.D. thesis, University of Birmingham.

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Background: Pulmonary arterial hypertension (PAH) is a recognised complication of SLE. The risk of developing PAH in SLE may be increased in a subset of patients with antiphospholipid antibodies.

Aims: To estimate the point prevalence of PAH, to evaluate screening tests and to identify risk factors for PAH in a large cohort of SLE patients

Methods: A prospective cross-sectional study of 288 patients with SLE using resting transthoracic echocardiography to estimate the systolic pulmonary artery pressures (sPAP) and to assess cardiac morphology and function. We assessed potential risk factors such as the presence of lung disease, autoantibodies and anti-phospholipid syndrome (APS). We evaluated screening tests such as pulmonary function tests, six minute walk test and biomarkers.

Results: Twelve out of 283 patients had PAH with sPAP >30 mm Hg (range 31-59 mmHg). Only 3 patients had sPAP >40 mm Hg. The only significant risk factor for PAH was lupus anticoagulant (p=0.005).

Conclusion: The point prevalence of PAH was 4.2% in our cohort of patients with SLE. The significant association of lupus anticoagulant and presence of APS in PAH cases suggests that thrombosis may play an important role in the development of PAH with SLE patients.

Type of Work:M.D. thesis.
Supervisor(s):Gordon, Caroline and Thickett, David
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Immunity and Infection, Rheumatology Research Group
Subjects:RC Internal medicine
Institution:University of Birmingham
ID Code:4195
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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