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

Prabu, Athiveeraramapandian (2013). Prevalence and risk factors for pulmonary arterial hypertension in patients with lupus. University of Birmingham. M.D.

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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: Thesis (Higher Doctorates > M.D.)
Award Type: Higher Doctorates > M.D.
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Immunity and Infection
Funders: None/not applicable
Subjects: R Medicine > RC Internal medicine


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