Browse ATS 2021 Abstracts

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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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Pulmonary Function Test Predictors of Pulmonary Vascular Resistance in Connective Tissue Disease Associated Interstitial Lung Disease (CTD-ILD)

Session Title
TP24 - TP024 UNDERSTANDING AND TREATING AUTOIMMUNE LUNG DISEASE
Abstract
A1802 - Pulmonary Function Test Predictors of Pulmonary Vascular Resistance in Connective Tissue Disease Associated Interstitial Lung Disease (CTD-ILD)
Author Block: D. Jain1, E. S. Randhawa2, G. J. Criner2, E. Narewski2; 1Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States, 2Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States.
Rationale: Pulmonary hypertension (PH) is a common and serious complication of interstitial lung disease (ILD), particularly in patients with connective tissue disease associated lung disease (CTD-ILD).1,2 The gold-standard for PH diagnosis is right heart catherization (RHC), with pulmonary vascular resistance (PVR) ≥ 3 Woods units (WU) and mean pulmonary artery pressure (mPAP) > 20 mmHg.3 The utility of pulmonary function tests in predicting PH within the diverse category of CTD-ILD patients is unknown.
Methods: We conducted a retrospective chart review of 100 sequential patients with a diagnosis of CTD by American College of Rheumatology criteria who received care at the Temple Lung Center in Philadelphia, PA between 2013-2020 for CTD-ILD. 32 patients were excluded based on initial comorbid diagnosis of cancer, end stage renal disease, end stage liver disease, or incomplete data for analysis. An additional 28 patients were excluded who did not undergo RHC. Patients were separated into two groups based on PVR: PVR < 3 WU and PVR ≥ 3 WU and pulmonary function test results, including spirometry, lung volumes, diffusion capacity for carbon monoxide (DLCO), and the six-minute walk test (6MW) were compared between groups.
Results: Of the 50 patients analyzed, 18 (36%) had a PVR < 3 WU and 32 (64%) had a PVR ≥ 3 WU. There were no statistically significant differences in demographic factors, spirometry, or lung volumes between the two groups (Table 1). CTD-ILD patients with a PVR < 3 WU had a significantly higher DLCO than those with a PVR ≥ 3 WU (p=0.008). A trend was present suggesting that CTD-ILD patients with a PVR < 3 WU had a greater distance walked during 6MW (293±96 meters) than those with a PVR ≥ 3 WU (250±101 meters), a difference greater than the minimal clinically important difference for the test.
Conclusion: In this small sample of patients with CTD-ILD, DLCO and 6MW distance may predict PVR.
References: 1. Andersen CU, et al. Pulmonary hypertension in interstitial lung disease: Prevalence, prognosis and 6 min walk test. Respir Med. 2012;106(6):875-882.
2. Young A, et al. Prevalence, Treatment, and Outcomes of Coexistent Pulmonary Hypertension and Interstitial Lung Disease in Systemic Sclerosis. Arthritis Rheumatol. 2019 Aug;71(8):1339-1349.
3.Simonneau G, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019;53(1).