Pulmonary arterial hypertension associated with systemic sclerosis in patients with functional class II dyspnoea: mild symptoms but severe outcome

Rheumatology (Oxford). 2010 May;49(5):940-4. doi: 10.1093/rheumatology/kep449. Epub 2010 Feb 8.

Abstract

Objective: To describe the history of SSc-associated pulmonary arterial hypertension (SSc-PAH) in patients with New York Heart Association (NYHA) functional class (FC) II dyspnoea at diagnosis.

Methods: Data at the time of diagnosis were collected and analysed retrospectively for 77 consecutive patients with SSc-PAH.

Results: Twelve patients (15.6%) presented with PAH and NYHA FC II dyspnoea. After a mean follow-up of 44 months, only 4 out of the 12 PAH patients remained stable in FC II, while 8 showed worsening to FC III or IV. Three patients died during the observation period; two from PAH and one from rectal cancer. Survival in patients in FC II at diagnosis was 100, 91 and 80% at 1, 2 and 3 years, respectively.

Conclusions: A majority of patients with mildly symptomatic SSc-PAH in NYHA FC II at diagnosis have a severe disease with poor prognosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Dyspnea / complications*
  • Dyspnea / physiopathology
  • Female
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / physiopathology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / physiopathology
  • Severity of Illness Index*
  • Time Factors