Hilal Erken PAMUKÇU, Çağatay TUNCA, Cem ÖZİŞLER, Veysel Ozan TANIK, Bahar TEKİN TAK, Saadet DEMİRTAŞ, Ali Erhan OZDEMIREL, Melih PAMUKCU, Tolga Han EFE

Türkiye’de tersiyer bir merkezde sistemik skleroz hastalarında pulmoner hipertansiyon taraması; kesitsel orjinal çalışma

Amaç: Sistemik Sklerozda (SS) Pulmoner Hipertansiyon (PH) gelişimi hastalığın sürvisini önemli ölçüde azaltmaktadır ve erken tanı ve tedavi çok önemlidir. Çalışmamızda SS tanısıyla romatoloji kliniği tarafından takip ve tedavi altında olan ve ve bilinen PH tanısı olmayan hastaların PH varlığı açısından taranması amaçlanmıştır.Gereç ve Yöntemler: Bu kesitsel çalışma SS tanısı olan 51 hasta ve cinsiyet ve komorbidite açısından benzer özellikte 51 gönüllüden oluşan kontrol grubuyla tamamlandı. Demografik, laboratuvar ve ekokardiyografik verileri kayıt edildi.Bulgular: Sistemik skleroz hasta grubunun ortanca yaşı 53 (46-60), kontrol grubunun 50 (45-55) idi. SS hastalarının 42 (%82,4)’si kadın, kontrol grubunun 39 (%76,5)’sı kadın cinsiyetten oluşmaktaydı. Transtorasik ekokardiyografide pulmoner arter basıncı yüksek saptanan (>40 mmHg) 3 hastaya sağ kalp kateterizasyonu yapıldı. İkisinde grup 1 PH (%3,9); birinde grup 2 PH (%1,9) saptandıSonuç: Çalışmamızda, tersiyer bir merkezde sistemik skleroz tanısıyla takipli ve tedavi altında olan 51 hastada %5,8 oranında pulmoner hipertansiyon saptamış bulunmaktayız. Bu hastaların belirli sıklıklarla PH taramasından geçirilmiş olmasına rağmen bu bulguya ulaşmamız dikkat çekicidir. Muhtemelen sınırda pulmoner arter basınç yüksekliği olan hızlı progresyon gösteren hastaları saptadığımızı düşünmekteyiz. Çalışmamız, sınırda pulmoner arter basınç yüksekliği olan SS hastalarının daha sık taranması gerektiğini desteklemektedir.

Anahtar Kelimeler:

sistemik skleroz, pulmoner hipertansiyon, ekokardiografi, sağ kalp kateterizasyonu

Pulmonary hypertension screening in patients with systemic sclerosis, in a tertiary center, in Turkey; a cross-sectional original study

Aim: Development of Pulmonary Hypertension (PH) in Systemic Sclerosis (SS) significantly reduces the survival of the disease and early diagnosis and treatment is very important.The aim of this study was to investigate the presence of PH in patients who were followed and treated by rheumatology clinic with the diagnosis of SS and who did not have a known diagnosis of PH.Materials and Methods: This cross-sectional study was completed with 51 patients with SS and a control group of 51 volunteers with similar characteristics in terms of gender and comorbidity. Demographic, laboratory and echocardiographic data were recorded.Results: The median age of the patients with systemic sclerosis was 53 (46-60) years and the control group was 50 (45-55) years. 42 (82.4%) of the SS patients were female and 39 (76.5%) of the control group were female. Right heart catheterization was performed to 3 patients with high pulmonary artery pressure (>40 mmHg) on transthorasic echocardiography. Group 1 PH was diagnosed in two of three patients (3.9%); group 2 PH was diagnosed in one of three patients (1.9%).Conclusion: In our study, we detected pulmonary hypertension in 5.8% of 51 patients with systemic sclerosis in a tertiary center. Although these patients have undergone PH screening at certain frequencies, it is noteworthy that we achieved this finding. We believe that we have detected patients with pulmonary systolic pressure at the border and showing rapid progression. Our study supports the more frequent screening of SS patients with borderline pulmonary artery pressure elevation.

Keywords:

systemic sclerosis, pulmonary hypertension, echocardiography, right heart catheterization,

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