Pulmonary hypertension complicating pulmonary sarcoidosis

Huitema, Marloes P.; Grutters, Jan C.; Rensing, Benno J.; Reesink, Herre J.; Post, Marco C.

doi:10.1007/s12471-016-0847-1

Cited by 30 publications

(33 citation statements)

References 48 publications

(90 reference statements)

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“…8 is a proposed screening algorithm of sarcoidosis patients for possible SAPH based on prior recommendations. 43,48 All patients with dyspnea should be evaluated for possible SAPH. Chest imaging has been proposed as one method to decide who to screen more vigorously for SAPH.…”

Section: Diagnosis Of Sarcoidosis-associated Pulmonary Hypertensionmentioning

confidence: 99%

“…Chest imaging has been proposed as one method to decide who to screen more vigorously for SAPH. 48 For those patients without pulmonary fibrosis, one should consider the level of dyspnea and response to anti-inflammatory therapy. One study found that half of patients with persistent dyspnea who were then referred for right heart catheterization (RHC) were found to have PH.…”

Section: Diagnosis Of Sarcoidosis-associated Pulmonary Hypertensionmentioning

confidence: 99%

“…These recommendations are similar to recommendations for patients with systemic sclerosis. 56 The RHC is crucial to distinguish between 43,48 patients with pulmonary venous hypertension versus those with precapillary PH. In one study, 20 of 70 (29%) sarcoidosis patients with PH had left ventricular dysfunction.…”

Section: Diagnosis Of Sarcoidosis-associated Pulmonary Hypertensionmentioning

confidence: 99%

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Sarcoidosis-Associated Pulmonary Hypertension

Shlobin

Baughman

2017

Semin Respir Crit Care Med

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Sarcoidosis-associated pulmonary hypertension (SAPH) is found in 5 to 20% of sarcoidosis patients. Elevated pulmonary artery pressure may be due to multiple factors, including vasculocentric, parenchymal, and mechanical, as well as comorbidities such as cardiac sarcoidosis and sleep apnea. Most SAPH patients have fibrotic lung disease, but SAPH may be present in those without advanced parenchymal lung disease. Several features have been shown to suggest SAPH, including reduced DLCO, shortened 6-minute walk distance, with or without desaturation, and the presence of increased pulmonary artery to aorta ratio on CT scanning. Echocardiography remains an important tool for the evaluation of SAPH but may both over- or underestimate the severity of pulmonary artery pressure. Right heart catheterization remains the definitive test to make the diagnosis. There have been several reports on the value of different modalities of treating SAPH. These include prospective clinical trials and one double-blind placebo-controlled randomized trial. Evidence-based guidelines for treatment of SAPH are discussed in this review.

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Section: Diagnosis Of Sarcoidosis-associated Pulmonary Hypertensionmentioning

confidence: 99%

Section: Diagnosis Of Sarcoidosis-associated Pulmonary Hypertensionmentioning

confidence: 99%

Section: Diagnosis Of Sarcoidosis-associated Pulmonary Hypertensionmentioning

confidence: 99%

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Sarcoidosis-Associated Pulmonary Hypertension

Shlobin

Baughman

2017

Semin Respir Crit Care Med

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“…68 Treatment of sarcoidosis associated PH is not well established and includes antiinflammatory therapies, pulmonary vasodilators, anticoagulation, and oxygen. 68,69 Malignancy Pulmonary tumor thrombotic microangiopathy (PTTM) is a condition in which tumor cells embolize to the pulmonary circulation leading to activation of the coagulation cascade, thrombus formation, intimal proliferation, obstruction and subsequently PH. 70 Tumors commonly associated with tumor embolization include renal cell cancer (Fig.…”

Section: Sarcoidosismentioning

confidence: 99%

Mimickers of chronic thromboembolic pulmonary hypertension on imaging tests: a review

Narechania¹,

Renapurkar²,

Heresi³

2020

Pulm. circ.

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Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by mechanical obstruction of large pulmonary arteries secondary to one or more episodes of pulmonary embolism. Ventilation perfusion scan is the recommended initial screening test for this condition and typically shows multiple large mismatched perfusion defects. However, not all patients with an abnormal ventilation perfusion scan have CTEPH since there are other conditions that be associated with a positive ventilation perfusion scan. These conditions include in situ thrombosis, pulmonary artery sarcoma, fibrosing mediastinitis, pulmonary vasculitis and sarcoidosis, among others. Although these conditions cannot be distinguished from CTEPH using a ventilation perfusion scan, they have certain characteristic radiological features that can be demonstrated on other imaging techniques such as computed tomography scan and can help in differentiation of these conditions. In this review, we have summarized some key clinical and radiological features that can help differentiate CTEPH from the CTEPH mimics.

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“…Although the evolving landscape of pulmonary arterial hypertension (PAH) over the last two decades has generally been of improvement in disease awareness and survival, this has not been the case for pulmonary hypertension (PH) associated with interstitial lung disease (ILD). While common pathophysiological links of parenchymal and vascular remodelling are implicated in the development of PH in ILD, its prevalence varies widely according to the underlying aetiology and severity of the ILD and is commonly associated with the subtypes of idiopathic pulmonary fibrosis (IPF), sarcoidosis and connective tissue disorders (CTD) . Right heart catheter (RHC) is the gold standard diagnostic test; however, due to its invasive nature and resource intensity, a non‐invasive screening test that could reliably identify patients at high risk is more desirable.…”

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confidence: 99%