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Pulmonary function vascular index predicts prognosis in idiopathic interstitial pneumonia.
BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is associated with increased mortality in fibrotic idiopathic interstitial pneumonia (IIP). We hypothesize that baseline K(CO) (diffusing capacity of carbon monoxide/alveolar volume) and 6-month decline in K(CO) reflect PH, thus predicting mortality in IIP. METHODS: All IIP referrals (2004-2007) were identified (n = 269). 192 had pulmonary function at 6 months. Fifty-two (27%) died during follow-up (median 22.5 months). Outcome was evaluated for early (1 year from 6-month pulmonary function) and overall mortality. A vascular index best predicting mortality was identified (using baseline and 6-month decline in K(CO) ) and evaluated against PH at echocardiography. RESULTS: Baseline and 6-month decline in K(CO) were associated with early and overall mortality. A positive vascular index (baseline K(CO) % ≤ 50% and/or ≥15% decline in K(CO) at 6 months; n = 40) was strongly predictive of early and overall mortality. Neither a diagnosis of idiopathic pulmonary fibrosis nor PH predicted early death when incorporated into this model. In patients without baseline PH, with follow-up echocardiography (n = 60), a positive vascular index was associated with PH at follow-up. CONCLUSIONS: A vascular index comprised of baseline and 6-month decline in K(CO) strongly predicted increased mortality and development of PH on echocardiography. In, K(CO) may be an important marker for pulmonary vascular disease and its associated mortality.
|Title:||Pulmonary function vascular index predicts prognosis in idiopathic interstitial pneumonia.|
|Keywords:||Aged, Female, Fibrosis, Humans, Idiopathic Interstitial Pneumonias, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Pulmonary Diffusing Capacity, Pulmonary Emphysema, Respiratory Function Tests, Tomography, X-Ray Computed|
|UCL classification:||UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
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