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Features associated with pulmonary arterial hypertension in Chinese hospitalized systemic lupus erythematosus patients

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Abstract

Pulmonary arterial hypertension (PAH) is an increasingly recognized complication of systemic lupus erythematosus (SLE). This study aims to estimate the point prevalence of PAH and identify risk factors for PAH in a large cohort of hospitalized SLE patients. We have collected the medical records of patients hospitalized with SLE at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital. Resting transthoracic echocardiography (TTE) was used to estimate pulmonary artery pressure (PAP) and PAH was defined as systolic PAP (PASP) > 30 mmHg. Patients with other connective tissue diseases, aPL syndrome, left heart disease, valvular heart disease, congenital heart disease, HIV, and portal hypertension were excluded because of diseases affecting the PAP. We assessed potential risk factors for PAH such as thrombogenic factors, SLE clinical manifestations, laboratory abnormalities and disease activity. Ninety-five were diagnosed with PAH of 1639 patients with SLE. The presence of high fibrinogen, serositis, and thrombocytopenia were significantly higher in patients with PAH than in those without PAH (all P < 0.05). Multivariate logistic regression found the associations between high fibrinogen (OR = 1.629), serositis (OR = 2.866), and thrombocytopenia (OR = 1.825) with PAH. The point prevalence of PAH was 5.8% in our cohort of patients with SLE. The significant association of high fibrinogen, serositis, and thrombocytopenia with PAH suggested that hypercoagulable state, organ damage, and hematological abnormality may all contribute to the development of PAH in SLE. This is important, as it is treatable.

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Author notes

  1. Shu-zhen Xu and Yan Liang contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People’s Republic of China

    Shu-Zhen Xu,  Yan Liang, Rui-Xue Leng, Hai-Feng Pan & Dong-Qing Ye

  2. Anhui Province Key Laboratory of Major Autoimmune Diseases, 81 Meishan Road, Hefei, Anhui, 230032, China

    Shu-Zhen Xu, Rui-Xue Leng, Hai-Feng Pan & Dong-Qing Ye

  3. Department of Rheumatology and Immunology, Anhui Provincial Hospital Affiliated to Anhui Medical University, 17 Lujiang Road, Hefei, Anhui, 230001, China

    Xiang-Pei Li & Xiao-Mei Li

  4. Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, China

    Zong-Wen Shuai

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  1. Shu-Zhen Xu
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Correspondence to Dong-Qing Ye.

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This study was conducted with the approval of the ethics committee of Anhui Medical University and according to the Declaration of Helsinki principles.

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Xu, SZ., Yan Liang, Li, XP. et al. Features associated with pulmonary arterial hypertension in Chinese hospitalized systemic lupus erythematosus patients. Clin Rheumatol 37, 1547–1553 (2018). https://doi.org/10.1007/s10067-018-4056-8

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  • DOI: https://doi.org/10.1007/s10067-018-4056-8

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