Parikh Raj, O'Sullivan David M, Farber Harrison W
Division of Pulmonary, Critical Care and Sleep, Hartford Hospital Hartford Connecticut USA.
Department of Research Administration Hartford HealthCare Hartford Connecticut USA.
Pulm Circ. 2023 Aug 8;13(3):e12273. doi: 10.1002/pul2.12273. eCollection 2023 Jul.
Pulmonary hypertension (PH) results in increased morbidity and mortality in patients with interstitial lung disease (ILD). Early recognition of PH in this population is essential for planning diagnostic testing, initiating therapy, and evaluating for lung transplantation. The previously developed PH-ILD Detection tool has significant potential in the evaluation and treatment of ILD patients; the aim of this study was to validate the tool in an independent, multicenter cohort of patients. We conducted a retrospective review of prospectively collected data from 161 ILD patients. Patients were stratified into low- ( = 78, 48.4%), intermediate- ( = 54, 33.5%), and high-risk ( = 29, 18.0%) groups based on the score obtained with the tool. Intermediate- and high-risk patients underwent follow-up echocardiogram (TTE); 49.4% ( = 41) had an abnormal TTE suggestive of underlying PH. These patients underwent right heart catheterization; PH-ILD was diagnosed in 73.2% ( = 30) of these cases. The PH-ILD Detection tool has a sensitivity of 93.3%, specificity of 90.9%, and area-under-the-curve of 0.921 for diagnosing PH in ILD patients, validating the findings from the original study and establishing the tool as a fundamental resource for early recognition of PH in ILD patients.
肺动脉高压（PH）会导致间质性肺疾病（ILD）患者的发病率和死亡率升高。在这一人群中早期识别PH对于规划诊断测试、启动治疗以及评估肺移植至关重要。先前开发的PH-ILD检测工具在ILD患者的评估和治疗中具有巨大潜力；本研究的目的是在一个独立的多中心患者队列中验证该工具。我们对前瞻性收集的161例ILD患者的数据进行了回顾性分析。根据该工具获得的评分，将患者分为低风险组（n = 78，48.4%）、中风险组（n = 54，33.5%）和高风险组（n = 29，18.0%）。中风险和高风险患者接受了随访超声心动图（TTE）检查；49.4%（n = 41）的患者TTE异常，提示存在潜在的PH。这些患者接受了右心导管检查；其中73.2%（n = 30）的病例被诊断为PH-ILD。PH-ILD检测工具在诊断ILD患者的PH方面，敏感性为93.3%，特异性为90.9%，曲线下面积为0.921，验证了原始研究的结果，并将该工具确立为早期识别ILD患者PH的重要资源。
