All Title Author
Keywords Abstract

Echocardiographic Measurement of Pulmonary Arterial Pressure in Patients with Sarcoidosis

DOI: 10.4236/ojrd.2016.61002, PP. 7-13

Keywords: Sarcoidosis, PH, ECO, PFT, 6 MWT

Full-Text   Cite this paper   Add to My Lib


Introduction: Pulmonary hypertension (PH) is a significant complication and is poor prognostic factor for sarcoidosis. We evaluated various tests of diagnosis and treatment as well as the associations between PH and value of six-minute walk test (6 MWT) in sarcoidosis patients. Methods: This study was conducted with fifty patients with sarcoidosis. We grouped patients according to echocardiography. Results: PH prevalence in sarcoidosis was found to be 10%. In cases with likely PH, FEV1%, FVC%, MMF% was found to be lower. Although DLCO was less than 80% in the group of likely PH and over 80% in the other, there were no statistical differences between two groups. Mean value of FVC/DLCO ratio was 1.1 ± 0.38 in group of likely PH. There was no significant difference between groups. Mean distance of 6 MWT was 464 ± 105 m in all cases. There were no statistical differences between two groups in 6 MWT. Significant desaturation with exercise was observed in cases with PH (p = 0.007). Conclusion: In all stages, patients who have longer disease duration and abnormal pulmonary function tests, should be examined about PH. Patients should undergo 6 MWT and presence of desaturation after 6 MWT, even without hypoxemia, should be looked after and dealt with accordingly.


[1]  Musellim, B., Kumbasar, Ö. Ö. and Ongen, G. (2009) Epidemiological Features of Turkish Patients with Sarcoidosis. Respiratory Medicine, 103, 907-912.
[2]  Nunes, H., Humbert, M., Capron, F., Brauner, M., Sitbon, O., Battesti, J.P., Simonneau, G. and Valeyre, D. (2006) Pulmonary Hypertension Associated with Sarcoidosis: Mechanisms, Hemodynamic and Prognosis. Thorax, 61, 68-74.
[3]  Baughman, R.P., Engel, P.J., Taylor, L. and Lower, E.E. (2010) Survival in Sarcoidosis Associated Pulmonary Hypertension: The Importance of Hemodynamic Evaluation. Chest, 138, 1078-1085.
[4]  Bourbonnais, J.M. and Samavati, L. (2008) Clinical Predictors of Pulmonary Hypertension in Sarcoidosis. European Respiratory Journal, 32, 296-302.
[5]  Brauner, M., Grenier, P. and Mompoint, D. (1989) Pulmonary Sarcoidosis: Evaluation with High-Resolution CT. Radiology, 172, 467-471.
[6]  Huang, C., Heurich, A., Rosen, Y., Moon, S. and Lyons, H.A. (1979) Pulmonary Sarcoidosis: Roentgenographic, Functional and Pathologic Correlations. Respiration, 37, 337-345.
[7]  Sharma, O. (1994) Pulmonary Sarcoidosis: Radiographic Features. In: James, D.O., Ed., Sarcoidosis and Other Granulomatous Disorders, Marcel Dekker, New York, 213-245.
[8]  Fraser, R.G. and Pare, J.A.P. (1979) Diagnosis of Diseases of the Chest. W.B. Saunders Company, Philadelphia, 1659-1689.
[9]  Rizzato, G., Pezzano, A., Sala, G., Merlini, R., Ladelli, L., Tansini, G., et al. (1983) Right Heart Impairment in Sarcoidosis: Hemodynamic and Echocardiographic Study. European Journal of Respiratory Diseases, 64, 121-128.
[10]  ATS Statement (2002) Guidelines for the Six-Minute Walk Test. American Journal of Respiratory and Critical Care Medicine, 166, 111-117.
[11]  Arcasoy, S.M., Christie, J.D., Ferrari, V.A., Sutton, M.S., Zisman, D.A., Blumenthal, N.P., Pochettino, A. and Kotloff, R.M. (2003) Echocardiographic Assessment of Pulmonary Hypertension in Patients with Advanced Lung Disease. American Journal of Respiratory and Critical Care Medicine, 167, 735-740.
[12]  Palmero, V. and Sulica, R. (2010) Sarcoidosis-Associated Pulmonary Hypertension: Assessment and Management. Seminars in Respiratory and Critical Care Medicine, 31, 494-500.
[13]  European Society of Cardiology (ESC) and European Respiratory Society (ERS) (2009) Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension. European Heart Journal, 30, 2493-2537.
[14]  Judson, A.M. (2014) Pulmonary Sarcoidosis: A Guide for the Practicing Clinician. Humana Press, New York, 11-29.
[15]  Mihailovic-Vucinic, V., Zugic, V. and Videnovic-Ivanov, J. (2003) New Observations on Pulmonary Function Changes in Sarcoidosis. Current Opinion in Pulmonary Medicine, 9, 436-441.
[16]  Lynch III, J.P., Kazerooni, E.A. and Gay, S.E. (1997) Pulmonary Sarcoidosis. Clinics in Chest Medicine, 18, 755-785.
[17]  Harrison, B.D., Shaylor, J.M. and Stokes, T.C. (1991) Airflow Limitation in Sarciodosis. Respiratory Medicine, 85, 59-64.
[18]  Baughman, R.B., Sparkman, B.K. and Lower, E.E. (2007) Assessment in Sarcoidosis Six-Minute Walk Test and Health Status. Chest, 132, 207-213.
[19]  Alhamad, E.H. (2009) The Six-Minute Walk Test in Patients with Pulmonary Sarcoidosis. Annals of Thoracic Medicine, 4, 60-63.
[20]  Rasekaba, T., Lee, A.L., Naughton, M.T., Williams, T.J. and Holland, A.E. (2009) The Six-Minute Walk Test: A Useful Metric for the Cardiopulmonary Patient. Internal Medicine Journal, 39, 495-501.
[21]  Guzman, D.E., Farver, C., Parambil, J. and Culver, D.A. (2008) Pulmonary Hypertension Caused by Sarcoidosis. Clinics in Chest Medicine, 29, 549-563.
[22]  Handa, T., Sonoko, N. and Shinji, M. (2006) Incidence of Pulmonary Hypertension and Its Clinical Relevance in Patients with Sarcoidosis. Chest, 129, 1246-1252.
[23]  Sulica, R., Teirstein, A.S., Kakarla, S., Nemani, N., Behnegar, A. and Padilla, M.L. (2005) Distinctive Clinical, Radiographic, and Functional Characteristics of Patients With Sarcoidosis-Related Pulmonary Hypertension. Chest, 128, 1483-1489.
[24]  Nunes, H., Humbert, M. and Capron, F. (2006) Pulmonary Hypertension Associated with Sarcoidosis: Mechanisms, Haemodynamics and Prognosis. Thorax, 61, 68-74.
[25]  Shorr, A.F., Helman, D.L., Davies, D.B. and Nathan, S.D. (2005) Pulmonary Hypertension in Advanced Sarcoidosis: Epidemiology and Clinical Characteristics. European Respiratory Journal, 25, 783-788.
[26]  Bourbonnais, J.M. and Samavati, L. (2008) Clinical Predictors of Pulmonary Hypertension in Sarcoidosis. European Respiratory Journal, 32, 296-302.
[27]  Steen, V.D., Graham, G., Conte, C., Owens, G. and Medsger Jr., T.A. (1992) Isolated Diffusing Capacity Reduction in Systemic Sclerosis. Arthritis & Rheumatology, 35, 765-770.
[28]  Nathan, S.D., Shlobin, O.A., Ahmad, S., Urbanek, S. and Barnett, S.D. (2007) Pulmonary Hypertension and Pulmonary Function Testing in Idiopathic Pulmonary Fibrosis. Chest, 131, 657-663.
[29]  Rosen, Y., Moon, S., Huang, C.T., Gourin, A. and Lyons, H.A. (1977) Granulomatous Pulmonary Agilities in Sarcoidosis. Archives of Pathology & Laboratory Medicine, 101, 170-174.


comments powered by Disqus

Contact Us


微信:OALib Journal