Rheumatology Medical News about systemic sclerosis;overlap of coronary disease and pulmonary arterial hypertension

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Overlap of coronary disease and pulmonary arterial hypertension in systemic sclerosis
Annals of Rheumatic Diseases, 02/13/09

Komócsi A et al. – Pulmonary arterial hypertension (PAH), coronary artery disease (CAD), and reduced coronary flow reserve (CFR) show a considerable overlap in symptomatic systemic sclerosis (SSc) patients. The current non-invasive investigations are neither sensitive nor specific enough to make an appropriate distinction between these different disease manifestations; a more invasive approach, such as coronary angiography at the initial catheterization is required.

Methods

Investigation of the extent of overlap between CAD and PAH in pts with SSc
20/120 pts were supposed to have PAH ('suspected PAH' group)
Another 10 pts showed the signs of coronary disease ('suspected CAD' group)
In these 30 pts, both right heart catheterization and coronary angiography were performed
CFR was assessed by thermodilution technique

Results

In the 'suspected PAH' and the 'suspected CAD' groups, PAH was found in 12/20 and 2/10 cases, coronary artery stenosis was in 9/20 and 6/10 cases
Severely reduced CFR was revealed in 7/20 and 3/10 cases, respectively

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