title: Pulmonary hypertension in advanced lung diseases: Echocardiography as an important part of patient evaluation for lung transplantation.
abstract: BACKGROUND
  Pulmonary hypertension (PH) is common complication in advanced lung disease. Echocardiography provides additional information and may be useful to assess PH probability.
  
  
  OBJECTIVE
  The usefulness of combination of well-known echocardiographic parameters in detecting PH in patients with advanced lung disease referred for lung transplantation was evaluated.
  
  
  METHODS
  The study population consisted of 37 consecutive patients with idiopathic pulmonary fibrosis (IPF), 20 patients with chronic obstructive pulmonary disease (COPD), and 8 patients with other interstitial lung diseases. PH was defined as mean pulmonary arterial pressure (mPAP) ≥25 mm Hg diagnosed by cardiac catheterization.
  
  
  RESULTS
  PH was present in 67.6% of enrolled IPF patients, 30% of enrolled COPD patients, and 75% of patients with other interstitial lung diseases. The receiver operating characteristics (ROC) curve analysis demonstrated right ventricular systolic pressure (RVSP) ≥43 mm Hg to be the threshold for PH prediction (n = 37, sensitivity 92.3%, specificity 81.8%, area under curve (AUC) 0.84, 95% confidence interval (CI) 0.67-1.0; P = .019). Right ventricular outflow tract (RVOT) diameter ≥34 mm and tricuspid annular plane systolic excursion (TAPSE) ≤18 mm had acceptable sensitivity, specificity and AUC (n = 65, 62.2%, 89.3%, 0.77, 95% CI 0.66-0.89; P = .11 and n = 62, 77.1%, 66.7%, 0.74, CI 0.61-0.87; P = .27, respectively). Combination of RVSP, RVOT and TAPSE, obtained in 36 patients, increased the sensitivity and negative predictive value (NPV) to 100%.
  
  
  CONCLUSIONS
  In patients with advanced lung diseases referred for lung transplantation the combination of RVSP, RVOT diameter, and TAPSE may be helpful in PH exclusion.
authors.affiliation: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Nowak
authors.affiliation: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Bartosz
authors.identifier: http://orcid.org/0000-0003-3880-5325
authors.initials: B
authors.lastname: Hudzik
authors.affiliation: Department of Lung Diseases and Tuberculosis, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Jastrzȩbski
authors.affiliation: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Jacek T
authors.initials: JT
authors.lastname: Niedziela
authors.affiliation: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Rozentryt
authors.affiliation: Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Wojarski
authors.affiliation: Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Ochman
authors.affiliation: Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Karolak
authors.affiliation: Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Żegleń
authors.affiliation: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Gierlotka
authors.affiliation: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gąsior
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D054990:Idiopathic Pulmonary Fibrosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D016040:Lung Transplantation / Q000592:standards; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D014261:Tricuspid Valve / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000070857:Walk Test / Q000379:methods
keywords: echocardiography; lung transplantation; pulmonary disease; pulmonary hypertension