Gupta Saurabh, Padhan Prasanta, Subhankar Saswat, Singh Pratima
Department of Pulmonary Medicine, Kalinga Institute of Medical Sciences, KIIT University, Patia, Bhubaneswar, Odisha, India.
Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Patia, Bhubaneswar, Odisha, India.
J Family Med Prim Care. 2021 Sep;10(9):3330-3335. doi: 10.4103/jfmpc.jfmpc_350_21. Epub 2021 Sep 30.
Pulmonary hypertension and other cardiac complications occur frequently due to chronic hypoxia induced by interstitial lung diseases (ILD) or due to connective tissue disorder itself. Two-dimensional (2D) echocardiography is ideal for identifying abnormalities at a given time. In this study, we tried to detect cardiovascular complications in patients with ILD using 2D echocardiography and correlate them with a 6-minute walk test (6 MWT) and spirometry.
This study was carried out for 18 months including 100 consecutive cases of ILD. The diagnosis was made using the latest criteria as per the disease and high-resolution computed tomography (HRCT) thorax. All patients were evaluated with 2D echocardiography, 6 MWT, and spirometry along with routine investigations. Their results were analyzed using STATA 15.1 software.
Cardiovascular involvement was detected in 68% of cases. Pulmonary hypertension predominated with a prevalence of 50%. In spirometry, mean Forced expiratory volume in first second (FEV)and Forced vital capacity (FVC) were found to be 54.96 (L) and 53.49 (L), respectively, with a predominant restrictive pattern (89%). There was a significant correlation between baseline saturation of oxygen (SpO) and pulmonary arterial systolic pressure (PASP) with a value of <0.05. Baseline SpO and distance covered in 6 MWT had a significant correlation ( = 0.014).
A baseline or nighttime hypoxia is responsible for developing PAH. Pulmonary arterial hypertension should be suspected in patients unable to perform 6 MWT or having low baseline SpO. A routine follow-up with a 6 MWT and baseline SpO should be performed in each visit to identify early deterioration of the disease.
由于间质性肺疾病（ILD）引起的慢性缺氧或结缔组织疾病本身，肺动脉高压和其他心脏并发症经常发生。二维（2D）超声心动图非常适合在特定时间识别异常情况。在本研究中，我们试图使用2D超声心动图检测ILD患者的心血管并发症，并将其与6分钟步行试验（6MWT）和肺功能测定相关联。
本研究进行了18个月，纳入100例连续的ILD病例。根据疾病的最新标准和胸部高分辨率计算机断层扫描（HRCT）进行诊断。所有患者均接受2D超声心动图、6MWT和肺功能测定以及常规检查。使用STATA 15.1软件分析他们的结果。
68%的病例检测到心血管受累。肺动脉高压占主导，患病率为50%。在肺功能测定中，第一秒用力呼气量（FEV）和用力肺活量（FVC）的平均值分别为54.96（L）和53.49（L），主要为限制性模式（89%）。氧基线饱和度（SpO）与肺动脉收缩压（PASP）之间存在显著相关性，P值<0.05。基线SpO与6MWT中行走的距离有显著相关性（P = 0.014）。
基线或夜间缺氧是发生肺动脉高压的原因。对于无法进行6MWT或基线SpO较低的患者，应怀疑有肺动脉高压。每次就诊时应进行6MWT和基线SpO的常规随访，以识别疾病的早期恶化。
