title: SAPHIRE: Stress and Pulmonary Hypertension in Rheumatoid Evaluation-A Prevalence Study.
abstract: Pulmonary artery hypertension (PAH) is a disorder of elevated resistance in the pulmonary arterial vessels, reflected by elevation of measured pulmonary artery pressure (PAP), and presenting with breathlessness and, if untreated, progressing to right heart failure and death. The heightened prevalence of PAH in populations with underlying systemic autoimmune conditions, particularly scleroderma and its variants, is well recognised, consistent with the proposed autoimmune contribution to PAH pathogenesis, along with disordered thrombotic, inflammatory, and mitogenic factors. Rheumatoid arthritis (RA) is one of a group of systemic autoimmune conditions featuring inflammatory symmetrical erosive polyarthropathy as its hallmark. This study explored the prevalence of PAH in a population of unselected individuals with RA, using exercise echocardiography (EchoCG). The high prevalence of EchoCG-derived elevation of PAP (EDEPP) in this population (14%) suggests that, like other autoimmune conditions, RA may be a risk factor for PAH. Patients with RA may therefore represent another population for whom PAH screening with noninvasive tools such as EchoCG may be justified.
authors.affiliation: John Hunter Hospital, University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: G E M
authors.identifier: 0000-0003-0776-8867
authors.initials: GE
authors.lastname: Reeves
authors.affiliation: Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Collins
authors.affiliation: Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Hayes
authors.affiliation: Autoimmune Resource and Research Centre, New Lambton Heights, NSW 2305, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Knapp
authors.affiliation: Autoimmune Resource and Research Centre, New Lambton Heights, NSW 2305, Australia.
authors.forename: M
authors.identifier: 0000-0002-3238-370X
authors.initials: M
authors.lastname: Squance
authors.affiliation: Pathology North, New Lambton Heights, NSW 2305, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Tran
authors.affiliation: Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Bastian