ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Markers of Pulmonary Hypertension in CTD-ILD of Patients with NSIP vs UIP
Session Title
TP24 - TP024 UNDERSTANDING AND TREATING AUTOIMMUNE LUNG DISEASE
Abstract
A1796 - Markers of Pulmonary Hypertension in CTD-ILD of Patients with NSIP vs UIP
Author Block: E. S. Randhawa1, D. Jain2, H. Zhao1, G. J. Criner3, E. Narewski4; 1Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 2Internal Medicine, Temple University, Philadelphia, PA, United States, 3Pulm & Crit Care Med, Temple Univ Hosp, Philadelphia, PA, United States, 4Department of Thoracic Medicine and Surgery, Temple Hospital, Philadelphia, PA, United States.
Introduction: Pulmonary hypertension (PH) is a common and severe comorbidity in patients with connective tissue disease associated interstitial lung disease (CTD-ILD), a diverse population with diverse prognoses. Nonspecific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP) are common interstitial lung disease patterns with significant prognostic implications. We hypothesized that patients with a UIP pattern of lung disease would be more likely to develop comorbid PH, and therefore may benefit more from PH screening. Methods: We performed a retrospective chart review of sequential patients diagnosed with CTD-ILD and receiving care at Temple Lung Center between 2013 and 2020. Each patient underwent high resolution computed tomography (HRCT) imaging of the chest at time of ILD diagnosis. Exclusion criteria included comorbid diagnoses of the human immunodeficiency virus (HIV), venous thromboembolism, cancer, end stage renal disease, and end stage liver disease. In an initial analysis we identified 78 patients, of whom 68 had CT findings consistent with NSIP or UIP and of whom 45 underwent right heart catheterization (RHC). We then compared parameters associated with a diagnosis of PH in patients with NSIP and patients with UIP as identified by HRCT or RHC. Results: Of the 68 patients, 44 had NSIP and 24 had UIP. Using the HRCT images, the mean PA diameter (in millimeters) was 31.0±5.8 and 31.4±6.2 in the NSIP and UIP groups, respectively, with a mean pulmonary artery (PA) to aorta (A) ratio (PA/A) of 1.04±0.19 and 1.02±0.23. Of the 45 patients who underwent RHC, 27 of whom had NSIP and 18 of whom had UIP, there was also no difference between mean PA pressure or pulmonary vascular resistance (PVR) between groups. Conclusions: In this small group of CTD-ILD patients with different patterns of lung disease, we found that pulmonary hypertension was a frequent complication of CTD-ILD patients with both NSIP and UIP.
Author Block: E. S. Randhawa1, D. Jain2, H. Zhao1, G. J. Criner3, E. Narewski4; 1Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, United States, 2Internal Medicine, Temple University, Philadelphia, PA, United States, 3Pulm & Crit Care Med, Temple Univ Hosp, Philadelphia, PA, United States, 4Department of Thoracic Medicine and Surgery, Temple Hospital, Philadelphia, PA, United States.
Introduction: Pulmonary hypertension (PH) is a common and severe comorbidity in patients with connective tissue disease associated interstitial lung disease (CTD-ILD), a diverse population with diverse prognoses. Nonspecific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP) are common interstitial lung disease patterns with significant prognostic implications. We hypothesized that patients with a UIP pattern of lung disease would be more likely to develop comorbid PH, and therefore may benefit more from PH screening. Methods: We performed a retrospective chart review of sequential patients diagnosed with CTD-ILD and receiving care at Temple Lung Center between 2013 and 2020. Each patient underwent high resolution computed tomography (HRCT) imaging of the chest at time of ILD diagnosis. Exclusion criteria included comorbid diagnoses of the human immunodeficiency virus (HIV), venous thromboembolism, cancer, end stage renal disease, and end stage liver disease. In an initial analysis we identified 78 patients, of whom 68 had CT findings consistent with NSIP or UIP and of whom 45 underwent right heart catheterization (RHC). We then compared parameters associated with a diagnosis of PH in patients with NSIP and patients with UIP as identified by HRCT or RHC. Results: Of the 68 patients, 44 had NSIP and 24 had UIP. Using the HRCT images, the mean PA diameter (in millimeters) was 31.0±5.8 and 31.4±6.2 in the NSIP and UIP groups, respectively, with a mean pulmonary artery (PA) to aorta (A) ratio (PA/A) of 1.04±0.19 and 1.02±0.23. Of the 45 patients who underwent RHC, 27 of whom had NSIP and 18 of whom had UIP, there was also no difference between mean PA pressure or pulmonary vascular resistance (PVR) between groups. Conclusions: In this small group of CTD-ILD patients with different patterns of lung disease, we found that pulmonary hypertension was a frequent complication of CTD-ILD patients with both NSIP and UIP.
