title: Noninvasive assessment of systolic pulmonary artery pressure in systemic lupus erythematosus: retrospective analysis of 93 patients.
abstract: OBJECTIVE
  To describe the frequency of patients with an elevated systolic pulmonary artery pressure (sPAP) estimated by Doppler echocardiography in a population of SLE patients followed in a tertiary reference centre.
  
  
  METHODS
  A search of our Internal Medicine Department database identified 93 SLE patients followed between 1995 and 2005. Their medical records were reviewed retrospectively. The PH threshold was defined as sPAP≥35mmHg. Characteristics of PH and non-PH SLE patients were compared using Fisher's, chi-square or Wilcoxon's exact test.
  
  
  RESULTS
  Elevated sPAP was detected in 12/93 (13%) patients. When analysing the mechanisms of PH, it was considered as secondary to specific lung involvement in 2 cases, due to severe left ventricular dysfunction in 1 patient and probably corresponding to SLE-associated PAH in the 9 remaining subjects. Univariate analyses showed that sPAP≥35mmHg was more common in Black subjects (50 vs. 20%, p=0.03), in patients with longer disease duration (14±8 vs. 9.5±8 years, p=0.049), and in patients with a history of peripheral nervous system involvement (25 vs. 4%, p=0.02), pericarditis (58 vs. 27%, p=0.04), anti-Sm (42 vs. 11%, p=0.01), and anticardiolipin antibodies (75 vs. 31% p=0.007).
  
  
  CONCLUSIONS
  PH is a relatively common complication of SLE patients managed in tertiary care centres. Doppler echocardiography allows non-invasive detection of elevated sPAP in this population that should then benefit from gold-standard techniques including right-heart catheterisation in order to confirm the diagnosis, as well as the cause and severity of PH.
authors.affiliation: Department of Internal Medicine and French Referral Centre for Necrotising Vasculitides and Systemic Sclerosis, Cochin Hospital, University Paris Descartes, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Foïs
authors.forename: V
authors.initials: V
authors.lastname: Le Guern
authors.forename: A
authors.initials: A
authors.lastname: Dupuy
authors.forename: M
authors.initials: M
authors.lastname: Humbert
authors.forename: L
authors.initials: L
authors.lastname: Mouthon
authors.forename: L
authors.initials: L
authors.lastname: Guillevin
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D053208:Kaplan-Meier Estimate; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index