Pulmonary vasospasm in systemic sclerosis: noninvasive techniques for detection
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
In a subgroup of patients with systemic sclerosis (SSc), vasospasm affecting the pulmonary circulation may contribute to worsening respiratory symptoms, including dyspnea. Noninvasive assessment of pulmonary blood flow (PBF), utilizing inert-gas rebreathing (IGR) and dual-energy computed-tomography pulmonary angiography (DE-CTPA), may be useful for identifying pulmonary vasospasm. Thirty-one participants (22 SSc patients and 9 healthy volunteers) underwent PBF assessment with IGR and DE-CTPA at baseline and after provocation with a cold-air inhalation challenge (CACh). Before the study investigations, participants were assigned to subgroups: group A included SSc patients who reported increased breathlessness after exposure to cold air (n = 11), group B included SSc patients without cold-air sensitivity (n = 11), and group C patients included the healthy volunteers. Median change in PBF from baseline was compared between groups A, B, and C after CACh. Compared with groups B and C, in group A there was a significant decline in median PBF from baseline at 10 minutes (−10%; range: −52.2% to 4.0%; P < 0.01), 20 minutes (−17.4%; −27.9% to 0.0%; P < 0.01), and 30 minutes (−8.5%; −34.4% to 2.0%; P < 0.01) after CACh. There was no significant difference in median PBF change between groups B or C at any time point and no change in pulmonary perfusion on DE-CTPA. Reduction in pulmonary blood flow following CACh suggests that pulmonary vasospasm may be present in a subgroup of patients with SSc and may contribute to worsening dyspnea on exposure to cold.
Date Issued
2015-07-13
Date Acceptance
2014-12-30
Citation
Pulmonary Circulation, 2015, 5 (3), pp.498-505
ISSN
2045-8940
Publisher
University of Chicago Press
Start Page
498
End Page
505
Journal / Book Title
Pulmonary Circulation
Volume
5
Issue
3
Copyright Statement
© 2015 by the Pulmonary Vascular Research Institute. All rights reserved.
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Respiratory System
Cardiovascular System & Cardiology
scleroderma
pulmonary vasospasm
noninvasive
PERFUSED-BLOOD-VOLUME
DUAL-ENERGY CT
RAYNAUDS-PHENOMENON
ARTERIAL-HYPERTENSION
MYOCARDIAL-PERFUSION
DIFFUSING-CAPACITY
CARDIAC-OUTPUT
COLD-EXPOSURE
LUNG
SCLERODERMA
Publication Status
Published