title: Pulmonary hypertension in systemic lupus erythematosus: echocardiography-based definitions predict 6-year survival.
abstract: OBJECTIVE
  The aim of this study was to investigate whether a core of echocardiography-based definitions of pulmonary hypertension (PH), as proposed by the European Society of Cardiology, European Respiratory Society and International Society of Heart and Lung Transplantation (ESC/ERS/ISHLT), may predict long-term survival in patients with SLE.
  
  
  METHODS
  A post hoc analysis from a cohort of SLE patients followed over 6 years was performed. Clinical associations, serum biomarkers, autoantibody profile, length of survival and all-cause mortality were assessed.
  
  
  RESULTS
  Out of 115 patients from the original cohort, 55 satisfied our inclusion criteria and were grouped according to echocardiography as unlikely (n = 26), possible (n = 16) or likely (n = 13) to have PH. Likely PH was associated with a history of pulmonary thromboembolism, higher cumulated organ damage and active arthritis. The 6-year survival rate was 88% in the unlikely PH group, 87% in the possible PH group and 68% in the likely PH group (P < 0.05). Serum levels of endothelin-1, monocyte chemotactic protein-1, IL-17, and IFN-γ as well as a number of autoantibodies were no different between groups.
  
  
  CONCLUSIONS
  The ESC/ERS/ISHLT echocardiography-based definitions of PH are useful to predict 6-year mortality in SLE patients. A history of pulmonary thromboembolism and lung vasculitis/haemorrhage, cumulated organ damage and long-lasting disease are associated with PH in SLE.
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Claudia
authors.initials: C
authors.lastname: Hübbe-Tena
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Selma
authors.initials: S
authors.lastname: Gallegos-Nava
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Márquez-Velasco
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Diana
authors.initials: D
authors.lastname: Castillo-Martínez
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Jesus
authors.initials: J
authors.lastname: Vargas-Barrón
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Julio
authors.initials: J
authors.lastname: Sandoval
authors.affiliation: Department of Rheumatology, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Department of Dermatology, Hospital General de Zona 1-A Dr Rodolfo Antonio de Mucha Macías, Instituto Mexicano del Seguro Social, Division of Research, Department of Echocardiography and Cardio Respiratory Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. lmamezcuag@gmail.com.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Amezcua-Guerra
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000150:complications; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014657:Vasculitis / Q000150:complications
keywords: MCP-1; echocardiography; endothelin-1; pulmonary hypertension; survival; systemic lupus erythematosus