Held M, Jonas-Klemm D, Jany B H
Missionsärztliche Klinik GmbH Würzburg, Abteilung Innere Medizin (Chefarzt Prof. Dr. med. Berthold Jany).
Pneumologie. 2013 Sep;67(9):502-8. doi: 10.1055/s-0033-1344553. Epub 2013 Sep 4.
The reported prevalence of pulmonary hypertension (PH) in sarcoidosis is variable and depends on the ethnic background, the underlying pathophysiology and the diagnostic methods used. We aimed to analyse the prevalence and the severity of PH and its relationship to ventilation and gas exchange in sarcoidosis.
We performed a retrospective analysis of echocardiography, pulmonary function tests, blood gases and right heart catheterisation of 123 patients with sarcoidosis.
5.6 % of all patients showed pulmonary hypertension. Parenchymal lung abnormalities (seen in 59.4 % of all patients) had no influence on PH. In patients with PH VC (p < 0.001), FEV1 (p < 0.001), FEV1/VC (p = 0.01), TLCO/VA (p < 0.001), pO2 (p = 0.04) and SO2 (p < 0.01), but not ITGV, TLC and RV were significantly lower. We found significant negative correlations for right ventricular systolic pressure (RVSP) and VC (R = -0.52, p < 0.01), FEV1 (R = -0.53, p < 0.01), DLCO-VA (R = -0.55, p = 0.02), pO2 (R = -0.69, p = 0.04) and SO2 (R = -0.91, p < 0.001).
Prevalence and severity of PH were similar to published Japanese data, but were less than reported in African-Americans. PH was associated with decreased vital capacity, forced exspiratory volume at one second and oxygenation; however, it was independent from parenchymal abnormalities. The influence of power of breathing on VC and FEV1 and its correlation with RVSP should be evaluated in a prospective trial.
