Hsieh Yu Jui, Ho Wan-Jing, Lin Chia-Pin, Luo Shue-Fen, Yu Kuang-Hui, Chen Ji-Yih, Hsiao Fu-Chih, Chang Chieh-Yu
Department of Cardiology.
Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Acta Cardiol Sin. 2023 May;39(3):469-479. doi: 10.6515/ACS.202305_39(3).20221104A.
Pulmonary arterial hypertension (PAH) is a rare but severe complication of connective tissue disease (CTD). CTD-associated PAH (CTD-PAH) is the most common subgroup of PAH in East Asia. We prospectively collected 41 patients with CTD-PAH and followed them for a mean period of 43 ± 36 months. The long-term survival rates of the CTD-PAH patients at 1, 2, 3 and 5 years were 90%, 80%, 77%, and 60%, respectively. The non-survivors had more dilated main pulmonary arteries, higher pulmonary artery pressure and pulmonary vascular resistance (PVR). PAH-specific therapy resulted in improvements in functional class, 6-minute walk distance, serum uric acid, right ventricular function and PVR. Increased C-reactive protein during follow-up, indicating inflammatory processes, was also crucial for the management of CTD-PAH. Therefore targeting both PAH and inflammation is important in this specific subgroup of PAH. The results of this study may help develop treatment strategies for CTD-PAH patients.
肺动脉高压(PAH)是结缔组织病(CTD)罕见但严重的并发症。CTD相关的PAH(CTD-PAH)是东亚地区PAH最常见的亚组。我们前瞻性收集了41例CTD-PAH患者,并对他们进行了平均43±36个月的随访。CTD-PAH患者1年、2年、3年和5年的长期生存率分别为90%、80%、77%和60%。非幸存者的主肺动脉更扩张,肺动脉压力和肺血管阻力(PVR)更高。PAH特异性治疗导致功能分级、6分钟步行距离、血清尿酸、右心室功能和PVR得到改善。随访期间C反应蛋白升高表明存在炎症过程,这对CTD-PAH的管理也至关重要。因此,针对PAH和炎症在这一特定PAH亚组中都很重要。本研究结果可能有助于制定CTD-PAH患者的治疗策略。