Does Reduced Lung Diffusing Capacity for Carbon Monoxide Predict the Presence of Pulmonary Hypertension?

作者：Delcour Kimberly S; Singla Atul; Jarbou Mohammad; Alpert Martin; Dabbagh Ousama^*

来源：American Journal of the Medical Sciences, 2010, 340(1): 54-59.

DOI：10.1097/MAJ.0b013e3181dd1a89

• Pulmonary hypertension
• Pulmonary function testing
• Diffusion capacity
• Transthoracic echocardiography
• Pulmonary vital capacity

Objective: The objective of this study was to determine whether reduced lung diffusing capacity for carbon monoxide (DLCO) predicts the presence of pulmonary hypertension (PH) in heterogeneous group of patients. Methods: Consecutive patients who underwent pulmonary function and transthoracic echocardiographic testing within a 6-month period were retrospectively identified by chart review. Right ventricular systolic pressure (RVSP) was measured using Doppler echocardiography. PH was defined as a RVSP >30 mm Hg. Patients were divided into 2 major groups: those whose RVSP was <= 30 mm Hg and those whose RVSP was >30 mm Hg. PH was classified as mild (RVSP = 31-40 mm Hg), moderate (RSVP = 41-60 mm Hg) and severe (RVSP >60 mm Hg). Results: A total of 398 patients were entered into the study: 264 (66.3%) with PH and 134 (33.7%) without PH. Patients with PH were older, had a lower mean percentage of predicted values for forced vital capacity (%FVC), for DLCO (% DLCO) and for DLCO corrected for alveolar volume (% DLCO/VA) than those without PH. Multivariate analysis identified age and % FVC as independent predictors of PH [odds ratios and 95% confidence intervals of 1.038 (1.020-1.056) and 0.972 (0.955-0.988), respectively]. There was a weak, but significant negative correlation between RVSP and % DLCO (r = -0.205, P = 0.001), but there was no correlation between RVSP and %DLCO/VA. Neither % DLCO nor % DLCO/VA was found to be independent predictors of PH. Conclusion: In a heterogeneous group of patients, % DLCO and % DLCO/VA do not independently predict the presence of PH.

• 出版日期2010-7