Volume 23, Issue 6 pp. 593-599
Original Article

Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema

Joseph Jacob

Corresponding Author

Joseph Jacob

Division of Radiology, Mayo Clinic Rochester, Rochester, MN, USA

Correspondence: Joseph Jacob, Division of Radiology, Mayo Clinic Rochester, 200 1st Street SW, Rochester, MN 55905, USA. Email: [email protected]Search for more papers by this author
Brian J. Bartholmai

Brian J. Bartholmai

Division of Radiology, Mayo Clinic Rochester, Rochester, MN, USA

Search for more papers by this author
Srinivasan Rajagopalan

Srinivasan Rajagopalan

Division of Radiology, Mayo Clinic Rochester, Rochester, MN, USA

Search for more papers by this author
Ronald Karwoski

Ronald Karwoski

Department of Physiology and Biomedical Engineering, Mayo Clinic Rochester, Rochester, MN, USA

Search for more papers by this author
Arjun Nair

Arjun Nair

Department of Radiology, Guys and St Thomas’ NHS Foundation Trust, London, UK

Search for more papers by this author
Simon L.F. Walsh

Simon L.F. Walsh

Department of Radiology, Kings College Hospital NHS Foundation Trust, London, UK

Search for more papers by this author
Joseph Barnett

Joseph Barnett

Department of Radiology, Royal Free Hospital, London, UK

Search for more papers by this author
Gary Cross

Gary Cross

Department of Radiology, Royal Free Hospital, London, UK

Search for more papers by this author
Eoin P. Judge

Eoin P. Judge

Interstitial Lung Disease Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK

Search for more papers by this author
Maria Kokosi

Maria Kokosi

Interstitial Lung Disease Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK

Search for more papers by this author
Elisabetta Renzoni

Elisabetta Renzoni

Interstitial Lung Disease Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK

Search for more papers by this author
Toby M. Maher

Toby M. Maher

Interstitial Lung Disease Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK

Search for more papers by this author
Athol U. Wells

Athol U. Wells

Interstitial Lung Disease Unit, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK

Search for more papers by this author
First published: 13 December 2017
Citations: 33
(Associate Editor: Helen Whitford; Senior Editor: Chris Grainge)
See relatedEditorial

ABSTRACT

Background and objective

This study evaluated whether patients with combined pulmonary fibrosis and emphysema (CPFE) have an increased likelihood of pulmonary hypertension (PHT) when compared with idiopathic pulmonary fibrosis (IPF) patients without emphysema.

Methods

Two consecutive IPF populations having undergone transthoracic echocardiography were examined (n = 223 and n = 162). Emphysema and interstitial lung disease (ILD) extent were quantified visually; ILD extent was also quantified by a software tool, CALIPER. Echocardiographic criteria categorized PHT risk.

Results

The prevalence of an increased PHT likelihood was 29% and 31% in each CPFE cohort. Survival at 12 months was 60% across both CPFE cohorts with no significantly worsened outcome identified when compared with IPF patients without emphysema.

Using logistic regression models in both cohorts, total computed tomography (CT) disease extent (ILD and emphysema) predicted the likelihood of PHT. After adjustment for total disease extent, CPFE had no stronger association with PHT likelihood than IPF patients without emphysema.

Conclusion

Our findings indicate that the reported association between CPFE and PHT is explained by the summed baseline CT extents of ILD and emphysema. Once baseline severity is taken into account, CPFE is not selectively associated with a malignant microvascular phenotype, when compared with IPF patients without emphysema.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.