This article appears in the following Rheumatology issue: Update in systemic sclerosis [View the issue table of contents]
Screening for PAH in patients with systemic sclerosis: focus on Doppler echocardiography
1Collagenosis and Pulmonary Hypertension Unit, University Hospital ‘Virgen del Rocío’, Seville, Spain, 2Department of Internal Medicine, DRK Kliniken Berlin, Berlin, Germany, 3Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland and 4Institute for Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Correspondence to: J. Sánchez-Román, Plaza de San Martín, 3-F 2a, 41003 Seville, Spain. E-mail: sanchezroman{at}nacom.es
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Abstract |
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It is well established that patients with CTDs such as SSc carry a considerable risk of developing pulmonary arterial hypertension (PAH). Such SSc-PAH patients have an even worse prognosis than patients with only one of these two conditions. In view of the high incidence and prevalence of PAH in SSc, and the available treatment options that improve quality of life, exercise capacity and possibly survival, systematic screening has been recommended. The present article reviews current recommendations from PAH guidelines, focusing on studies that used Doppler echocardiography for screening, and describes limitations associated with the procedure. Furthermore, characteristics and parameters used to identify patients at high risk of developing PAH are summarized.
KEY WORDS: Doppler echochardiography, Screening, Pulmonary arterial hypertension, Guidelines, Predictors
Submitted 30 April 2008; Accepted 3 July 2008