title: Borderline pulmonary arterial pressure in systemic sclerosis patients: a post-hoc analysis of the DETECT study.
abstract: BACKGROUND
  Patients with mean pulmonary artery pressures (mPAP) of 21 to 24 mm Hg have a so-called borderline elevation of mPAP (BoPAP)--a condition thought to represent early-stage pulmonary arterial vasculopathy. Based on the DETECT study, this post-hoc analysis examined patient characteristics of systemic sclerosis (SSc) patients with normal mPAP, BoPAP and elevated mPAP, fulfilling pulmonary arterial hypertension (PAH) criteria.
  
  
  METHODS
  Adult patients with a duration of SSc more than 3 years, a diffusing capacity of the lung for carbon monoxide less than 60% predicted, and no previous diagnosis of any form of pulmonary hypertension (PH) underwent screening tests followed by right heart catheterization. Subjects were divided into three groups: normal mPAP, BoPAP, and PAH. Exploratory comparative and binary logistic regression analyses were performed for the BoPAP versus normal mPAP and PAH versus BoPAP groups.
  
  
  RESULTS
  Of 244 patients evaluated, 148 (60%) had normal mPAP, 36 (15%) had BoPAP, and 60 (25%) had definite PAH. Univariable logistic regression (ULR) showed the mean tricuspid regurgitation velocity in patients with BoPAP to be intermediate between normal mPAP and PAH. In the ULR analyses BoPAP versus normal mPAP and PAH versus BoPAP, the statistically significant predictors were, amongst others: demographic, clinical, pulmonary function, echocardiographic and hemodynamic variables.
  
  
  CONCLUSIONS
  In this exploratory post-hoc analysis of the DETECT study population patients with BoPAP could be distinguished from patients with normal mPAP and PAH, and it appears that BoPAP may be an intermediate stage on the continuum between normal PA pressures and PAH.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Visovatti
authors.forename: Oliver
authors.initials: O
authors.lastname: Distler
authors.forename: J Gerry
authors.initials: JG
authors.lastname: Coghlan
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Denton
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Grünig
authors.forename: Diana
authors.initials: D
authors.lastname: Bonderman
authors.forename: Ulf
authors.initials: U
authors.lastname: Müller-Ladner
authors.forename: Janet E
authors.initials: JE
authors.lastname: Pope
authors.forename: Madelon C
authors.initials: MC
authors.lastname: Vonk
authors.forename: James R
authors.initials: JR
authors.lastname: Seibold
authors.forename: Juan-Vicente
authors.initials: JV
authors.lastname: Torres-Martin
authors.forename: Martin
authors.initials: M
authors.lastname: Doelberg
authors.forename: Harbajan
authors.initials: H
authors.lastname: Chadha-Boreham
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Rosenberg
authors.forename: Vallerie V
authors.initials: VV
authors.lastname: McLaughlin
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology*; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000503:physiopathology*