Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/35327
Title: Pulmonary hypertension in interstitial lung disease: a systematic review and meta-analysis.
Austin Authors: Ang, Hui Li;Schulte, Max;Chan, Roseanne Kimberley;Tan, Hann Hsiang;Harrison, Amelia ;Ryerson, Christopher J;Khor, Yet Hong
Affiliation: Royal Melbourne Hospital, Victoria, Australia.
Institute for Breathing and Sleep
Department of Cardiology, Western Health, Victoria, Australia.
Royal Sussex County Hospital, Brighton, United Kingdom.
Department of Respiratory and Sleep Disorders Medicine, Western Health, Victoria, Australia.
University of British Columbia, Vancouver, British Columbia, Canada; Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada.
Central Clinical School, Monash University, Victoria, Australia.
Respiratory and Sleep Medicine
Issue Date: 29-May-2024
Date: 2024
Publication information: Chest 2024-05-29
Abstract: Pulmonary hypertension (PH) is a key complication in interstitial lung disease (ILD), with recent therapeutic advances. What are the diagnostic evaluation, epidemiology, associated factors, prognostic significance, and outcome measures in interventional trials for PH in patients with ILD in current literature? Ovid MEDLINE, Embase, and CENTRAL databases were searched for original research evaluating PH in participants with ILD of any aetiology. The definition of PH was based on the investigators' criteria. 302 studies were included, with varying diagnostic evaluation used to define PH. Commonly used diagnostic tests were right heart catheterisation (RHC) (56%) and transthoracic echocardiogram (TTE) (50%). The pooled prevalence for PH in general ILD populations was 36% (95%CI 30-42%) using RHC, and 34% (95%CI 29-38%) using TTE. Lower diffusion capacity for carbon monoxide, worse oxygenation status, reduced exercise capacity, increased pulmonary artery to aorta ratio and pulmonary artery diameter, and elevated serum brain natriuretic peptide were consistently associated with the presence of PH in at least 60% of reported studies. The presence of PH was associated with increased symptom burden and worse prognosis. Outcome measures in interventional trials of PH in ILD focused on changes in pulmonary vascular haemodynamic and 6-minute walk distance. PH is a common complication in ILD with significant health impacts. A standardised definition with prospective evaluation of risk-stratified assessments for PH using identified associated risk factors is warranted. Our findings provide an evidence base for validation as surrogate endpoints in future PH interventional trials in ILD.
URI: https://ahro.austin.org.au/austinjspui/handle/1/35327
DOI: 10.1016/j.chest.2024.04.025
ORCID: 
Journal: Chest
PubMed URL: 38821182
ISSN: 1931-3543
Type: Journal Article
Subjects: interstitial lung disease
pulmonary hypertension
systematic review
Appears in Collections:Journal articles

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