Systemic sclerosis & Raynaud's
Screening for pulmonary arterial hypertension in patients with systemic sclerosis in the era of new pulmonary arterial hypertension definitions
Authors' conclusion
With the recent criteria, PAH diagnosis in patients with SSc increased by 1.8-fold. Current algorithms for screening PAH are less sensitive with these revised criteria. Although the ASIG algorithm seems more sensitive, it can still miss the diagnosis.
Study context
- Population
- Consecutive SSc patients without a previous diagnosis of pulmonary hypertension (PH)35 required right heart catheterisation (RHC)
- Participants
- 81 patients
- Comparison
- ESC/ERS vs DETECT vs Australian Scleroderma Interest Group (ASIG) pulmonary arterial hypertension (PAH) screening algorithms, by 2022 and 2015 ESC/ERS haemodynamic criteria
- Outcome
- Performance (sensitivity) of RHC referral for PAH according to the 2022 ESC/ERS PAH criteria
Methodological detailsconsecutive patients, real-life cohort
- Consecutive patients
- Real-life cohort
Performance
As reported in the abstract
Sensitivity for PAH diagnosis (2022 ESC/ERS definition)
| Test or model | Sensitivity |
|---|---|
| ESC/ERS | 62.5% |
| DETECT | 75% |
| ASIG | 87.5% |
Sensitivity
ESC/ERS62.5%
DETECT75%
ASIG87.5%
Further findings
Patients requiring RHC
Sensitivity for PAH diagnosis (previous ESC/ERS definition)
- Sensitivity of all algorithms
- 100%
- Only one patient diagnosed with PAH by previous criteria
Final diagnoses after RHC (2022 criteria)
- No PH
- 17
- WHO group 1 PH (PAH)
- 8
- WHO group 2 PH
- 8
- WHO group 3 PH
- 2
Original publication
Screening for pulmonary arterial hypertension in patients with systemic sclerosis in the era of new pulmonary arterial hypertension definitions. Clin Exp Rheumatol. Published 10 August 2023. doi:10.
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