Lung and pulmonary vascular disease in scleroderma, the role of ...

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Trans-Tricuspid pressure difference (echo) (mmHg) 1. Gibbs JSR. Eur Respir Rev 2007; 16:8-12. 2. Mukerjee D, et al. Rheumatology 2004;43:461-6. Limitations of echocardiography 100 80 60 40 False positive r 2 =0.4515 20 0 0 20 40 60 25 False negative mPAP (mmHg) measured invasively (RHC) 80
PAH screening algorithm at Royal Free SSc annual review Lung function Echo Questionnaire TG < 2.5 m/s DLCO > 55% No unexplained dyspnoea No other cardiac problems Courtesy of Prof Denton, Royal Free TG > 3 m/s TLCO < 55% + TLC > 80% or TG > 2.5 + any dyspnoea 20% fall in DLCO or New dyspnoea Other cardiac problem Cardiac catheterisation
Page 1 and 2: Lung and Pulmonary Vascular disease
Page 3 and 4: Overview • Respiratory diseases i
Page 5 and 6: Respiratory causes of dyspnoea in C
Page 7 and 8: Serological subsets in scleroderma
Page 9 and 10: Interstitial lung disease
Page 11 and 12: Non Specific Interstitial Pneumonit
Page 13 and 14: ILD - role of the Respiratory Physi
Page 15 and 16: Lung function testing • Volumes (
Page 17 and 18: Spirometry 1) Obstructive defect
Page 19 and 20: Lung function patterns SSc-ILD SSc-
Page 23 and 24: HRCT • Very sensitive • Allows
Page 25 and 26: HRCT extent 20% FVC>70% FVC
Page 27 and 28: Management • Supportive - Multidi
Page 29 and 30: Overview • Respiratory diseases i
Page 31 and 32: PH - a syndrome 1. Pulmonary Arteri
Page 33 and 34: PH - role of the Respiratory Physic
Page 35: Echo as a screening tool? PASP = 4
Page 39 and 40: PH - a syndrome 1. Pulmonary Arteri
Page 41: Take home points • SSc can be ass

Lung and pulmonary vascular disease in scleroderma, the role of ...

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