High sensitivity and negative predictive value of the DETECT algorithm for an early diagnosis of pulmonary arterial hypertension in systemic sclerosis : application in a single center
Guillén-Del Castillo, Alfredo (Hospital Universitari Vall d'Hebron)
Callejas Moraga, Eduardo Luis (Hospital Universitari Vall d'Hebron)
García, Gabriela (Hospital Universitari Vall d'Hebron)
Rodriguez-Palomares, Jose F (Hospital Universitari Vall d'Hebron)
Román, Antonio (Román Broto) (Hospital Universitari Vall d'Hebron)
Berastegui García, Cristina (Hospital Universitari Vall d'Hebron)
López-Meseguer, Manuel (Hospital Universitari Vall d'Hebron)
Domingo Ribas, Enric (Hospital Universitari Vall d'Hebron)
Fonollosa Pla, Vicent (Hospital Universitari Vall d'Hebron)
Simeón-Aznar, Carmen Pilar (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	Pulmonary arterial hypertension (PAH) is one of the most relevant causes of death in systemic sclerosis. The aims of this study were to analyse the recently published DETECT algorithm comparing it with European Society of Cardiology/European Respiratory Society (ESC/ERS) 2009 guidelines: as screening of PAH; (2) identifying median pulmonary arterial pressure (mPAP) ≥21 mmHg; and (3) determining any group of pulmonary hypertension (PH). Eighty-three patients fulfilling LeRoy's systemic sclerosis diagnostic criteria with at least right heart catheterization were studied retrospectively. Clinical data, serological biomarkers, echocardiographic and hemodynamic features were collected. SPSS 20. 0 was used for statistical analysis. According to right heart catheterization findings, 35 patients with PAH and 28 with no PH met the standards for DETECT algorithm analysis: 27. 0% of patients presented with functional class III/IV. Applying DETECT, the sensitivity was 100%, specificity 42. 9%, the positive predictive value 68. 6% and the negative predictive value 100%, whereas employing the ESC/ERS guidelines these were 91. 4%, 85. 7%, 88. 9% and 89. 3%, respectively. There were no missed diagnoses of PAH using DETECT compared with three patients missed (8. 5%) using ESC/ERS guidelines. The DETECT algorithm also showed greater sensitivity and negative predictive value to identify patients with mPAP ≥21 mmHg or with any type of PH. The DETECT algorithm is confirmed as an excellent screening method due to its high sensitivity and negative predictive value, minimizing missed diagnosis of PAH. DETECT would be accurate either for early diagnosis of borderline mPAP or any group of PH.
Ajuts:	Instituto de Salud Carlos III PI16-02088 Instituto de Salud Carlos III FI14-00643
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Systemic sclerosis ; Pulmonary arterial hypertension ; Echocardiography ; Screening tools
Publicat a:	Arthritis research & therapy, Vol. 19 (june 2017) , ISSN 1478-6362

DOI: 10.1186/s13075-017-1327-8
PMID: 28615037

10 p, 568.4 KB

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