Factors predicting pulmonary hypertension in idiopathic pulmonary fibrosis patients

• Published in: The Egyptian Journal of Bronchology 2015-04, Vol.9 (1), p.55-58
• Main Authors: Sadek, Samiaa H., Kasem, Soheir M.
• Format: Article
• Language: English
• Subjects: Interstitial Lung Diseases and Lung in Systemic Diseases; Medicine & Public Health; Pulmonary fibrosis; Pulmonary hypertension
• ISSN: 1687-8426; 2314-8551
• DOI: 10.4103/1687-8426.153607

Context Pulmonary hypertension (PH) is a common complication of idiopathic pulmonary fibrosis (IPF) and an important pathophysiologic mechanism of exercise intolerance and poor quality of life in these patients. Aims The aims of this study were to assess predictors of PH in IPF from both resting pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET) parameters and to establish cut-off values from resting PFT and CPET parameters for the prediction of PH. Settings and design This was a randomized, double-blind, and prospective study. Patients and methods Thirty-five patients with stable IPF were assessed in terms of resting pulmonary functions, arterial blood gases (ABG), echocardiography, and incremental CPET. Patients were classified into a PH group and a non-pulmonary-hypertension group. Statistical analysis Both groups were compared in terms of resting PFT and CPET parameters. A receiver operating characteristic curve was constructed to establish cut-off values for the prediction of PH. Results PH was observed in 13 (37.14%) patients. There were no significant differences between both groups in age and sex. forced vital capacity (FVC)%, forced expiratory volume in one second (FEV 1 )%, inspiratory capacity, resting and exercise partial arterial oxygen tension (PaO 2 ) and arterial oxygen saturation (SaO 2 ), and oxygen consumption (VO 2 %) were significantly reduced in the PH group, whereas the dyspnea score, resting and exercise PaCO 2 , respiratory frequency, and minute ventilation were significantly increased in the PH group. The receiver operating characteristic curve showed that resting SaO 2 of 92.9% or less and exercise SaO 2 of 87% or less had sensitivity of 84.6, and 100%, and specificity of 90.9 and 81.8%, respectively. Conclusion Marked deterioration in resting PFT, exercise parameters, and SaO 2 can predict PH in IPF patients.