title: Pulmonary Arterial Hypertension in Systemic Lupus Erythematosus: Prevalence and Predictors.
abstract: OBJECTIVE
  Pulmonary arterial hypertension (PAH) prevalence has been reported to be between 0.5% and 17% in systemic lupus erythematosus (SLE). This study assessed PAH prevalence and predictors in an SLE cohort.
  
  
  METHODS
  The Borg dyspnea scale, DLCO, N-terminal pro-brain natriuretic peptide (NT-proBNP), and Doppler echocardiographic (DE) were performed. An echocardiographic Doppler exercise test was conducted in selected patients. When DE systolic pulmonary arterial pressure was ≥ 45 mmHg or increased during exercise > 20 mmHg, a right heart catheterization was performed. Hemodynamic during exercise was measured if rest mean pulmonary arterial pressure was < 25 mmHg.
  
  
  RESULTS
  Of the 203 patients with SLE, 152 were included. The mean age was 44.9 ± 12.3 years, and 94% were women. Three patients had known PAH. The algorithm diagnosed 1 patient with chronic thromboembolic pulmonary hypertension and 5 with exercise-induced pulmonary artery pressure increase (4 with occult left diastolic dysfunction). These patients had significantly more dyspnea, higher NT-proBNP, and lower DLCO.
  
  
  CONCLUSIONS
  These data confirm the low prevalence of PAH in SLE. In our cohort, occult left ventricular diastolic dysfunction was a frequent diagnosis of unexplained dyspnea. Dyspnea, DLCO, and NT-proBNP could be predictors of pulmonary hypertension in patients with SLE.
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre. gperpen@gobiernodecanarias.org.
authors.forename: Gregorio Miguel
authors.initials: GM
authors.lastname: Pérez-Peñate
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Iñigo
authors.initials: I
authors.lastname: Rúa-Figueroa
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Juliá-Serdá
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Fernándo
authors.initials: F
authors.lastname: León-Marrero
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Antonio
authors.initials: A
authors.lastname: García-Quintana
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Ortega-Trujillo
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Celia
authors.initials: C
authors.lastname: Erausquin-Arruabarrena
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Lozano
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Pedro
authors.initials: P
authors.lastname: Cabrera-Navarro
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Nazario
authors.initials: N
authors.lastname: Ojeda-Betancor
authors.affiliation: From the Pneumology Service, Rheumatology Service, Cardiology Service, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín," Las Palmas de Gran Canaria; Cardiology Service, Hospital 12 de Octubre, Madrid, Spain.G.M. Pérez-Peñate, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; I. Rúa-Figueroa, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; G. Juliá-Serdá, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; F. León- Marrero, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; A. García-Quintana, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; J.R. Ortega-Trujillo, MD, Cardiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Erausquin-Arruabarrena, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; C. Rodríguez-Lozano, MD, Rheumatology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; P. Cabrera-Navarro, MD, Pneumology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; N. Ojeda-Betancor, MD, Anesthesiology Service, Hospital Universitario General de Gran Canaria "Doctor Negrín"; M.Á. Gómez-Sánchez, MD, Cardiology Service, Hospital 12 de Octubre.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Gómez-Sánchez
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D015995:Prevalence; D012307:Risk Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: DLCO; DOPPLER ECHOCARDIOGRAPHIC; N-TERMINAL PRO–BRAIN NATRIURETIC PEPTIDE; PULMONARY ARTERIAL HYPERTENSION; RIGHT HEART CATHETERIZATION; SYSTEMIC LUPUS ERYTHEMATOSUS