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Abstract: Poster Presentations |

INCIDENCE AND FACTORS ASSOCIATED WITH PULMONARY HYPERTENSION IN PATIENTS WITH ADVANCED LUNG DISEASE EVALUATED FOR LUNG TRANSPLANTATION FREE TO VIEW

Adriano R. Tonelli, MD*; Saba Lodhi, MD; Robin D. Carrie, ARNP-C; Olufemi A. Akindipe, MD; Sebastian Fernandez-Bussy, MD; Kamal Mubarak, MD; Maher A. Baz, MD
Author and Funding Information

University of Florida, Gainesville, FL


Chest


Chest. 2009;136(4_MeetingAbstracts):61S. doi:10.1378/chest.136.4_MeetingAbstracts.61S-b
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Abstract

PURPOSE:  We sought to identify the incidence of pulmonary hypertension (PH) in patients (pts) with advanced lung disease and recognize clinical and spirometrical variables associated with PH.

METHODS:  We included pts with advanced lung diseases who underwent right heart catheterization as part of their evaluation for lung transplantation at University of Florida from 1/2003 to 12/2008. Evaluated pts had the following lung diseases: chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), cystic fibrosis (CF), pulmonary fibrosis associated with collagen diseases (PF/CD), sarcoidosis, alpha-1 antitrypsin deficiency (AATD), idiopathic pulmonary arterial hypertension (IPAH) and others.

RESULTS:  A total of 281 pts were included (age 52.6 ± 12 years, 52% females). The percentage of pts with mean pulmonary artery pressure ≥ 25 mmHg, ≥ 45 mmHg and PVR ≥ 3 Wood Units was the following: COPD (n = 87, 60%, 3.4% and 36%), IPF (n = 81, 61%, 7.4%, 57%), CF (n = 25, 75%, 0%, 44%), PF/CD (n = 25, 60%, 16%, 50%), sarcoidosis (n = 23, 78%, 30%, 77%), AATD (n = 13, 58%, 0%, 58%), IPAH (n = 8, 100%, 88%, 100%) and others (n = 19, 39%, 11%, 33%). In parenchymal lung diseases, pts using 4 l/m or more of oxygen (n = 32, mPAP 39 versus 28 mmHg, p = 0.001), pts with sarcoidosis (n = 23, 39 versus 28 mmHg, p = 0.001) and pts with DLCO below 35% of predicted (n = 159, 30 versus 27 mmHg, p = 0.04) had significantly higher mPAP. Using multiple linear regression the mPAP in mmHg can be predicted (R2 change: 0.19) by the following equation: 27.15 + 10.41* use of 4 l/m (0 or 1)+ 2.1* diagnosis of sarcoidosis (0 or 1).

CONCLUSION:  The incidence of PH was high in pts evaluated for lung transplantation. Sarcoidosis and the need for oxygen ( > 4 l/m) are independently associated with higher pulmonary pressures in pts with advanced parenchymal lung diseases.

CLINICAL IMPLICATIONS:  PH is common in pts with advanced lung diseases evaluated for lung transplantation, predominantly in pts who carry the diagnosis of sarcoidosis or pts requiring more than 4 liters of oxygen.

DISCLOSURE:  Adriano Tonelli, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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