Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
Respiration. 2018;95(4):244-250. doi: 10.1159/000485631. Epub 2018 Feb 28.
Precapillary pulmonary hypertension (PH), and particularly pulmonary arterial hypertension (PAH), is a life-threatening complication of connective tissue diseases (systemic sclerosis, systemic lupus erythematosus, and mixed connective tissue disease). The relationship between PH and rheumatoid arthritis (RA) has not been clearly established.
The aim of the study was to evaluate the relationship between precapillary PH and RA.
We identified patients with PH and suspected RA included in the French PH Registry between 1 May 2004 and 31 December 2012 and evaluated the prevalence of confirmed RA in this population. RA phenotypes, clinical, functional, and hemodynamic data, and patient outcomes were recorded.
RA was confirmed in 20 patients (70% female; mean age 52 years) with precapillary PH, including 10 patients with PAH, 6 with severe PH due to lung disease, and 4 with chronic thromboembolic PH. The prevalence of RA was 0.35% (95% CI: 0.23-0.54) in the French PH Registry and 0.58% (95% CI: 0.30-1.11) in idiopathic PAH, comparable to that in the general population. The RA phenotype was characterized by the presence of specific RA autoantibodies and joint erosions in 75% of the patients. The outcomes of PH in the RA patients were unremarkable compared to those in other patients from the registry, and RA therapies had no major impact on the cardiopulmonary parameters.
When precapillary PH occurs in RA patients, all PH subsets may be identified. The RA prevalence in the French PH Registry is similar to that in the general population, which does not support a specific association or an indication for PH screening in RA patients.
毛细血管前肺动脉高压（PH），特别是肺动脉高压（PAH），是结缔组织疾病（系统性硬化症、系统性红斑狼疮和混合性结缔组织病）的一种危及生命的并发症。PH 与类风湿关节炎（RA）之间的关系尚未明确。
本研究旨在评估毛细血管前 PH 与 RA 之间的关系。
我们鉴定了 2004 年 5 月 1 日至 2012 年 12 月 31 日期间纳入法国 PH 登记处的 PH 合并疑似 RA 患者，并评估了该人群中确诊 RA 的患病率。记录了 RA 表型、临床、功能和血流动力学数据以及患者结局。
在毛细血管前 PH 患者中，有 20 例（70%为女性；平均年龄 52 岁）确诊为 RA，包括 10 例 PAH、6 例因肺部疾病引起的严重 PH 和 4 例慢性血栓栓塞性 PH。法国 PH 登记处 RA 的患病率为 0.35%（95%CI：0.23-0.54），特发性 PAH 为 0.58%（95%CI：0.30-1.11），与普通人群相当。RA 表型的特征是 75%的患者存在特定的 RA 自身抗体和关节侵蚀。与登记处的其他患者相比，RA 患者的 PH 结局无明显差异，并且 RA 治疗对心肺参数没有重大影响。
当 RA 患者发生毛细血管前 PH 时，可能会发现所有 PH 亚组。法国 PH 登记处的 RA 患病率与普通人群相似，这并不支持 RA 患者存在特定的关联或需要进行 PH 筛查。
