Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema

Joseph Jacob, Brian Jack Bartholmai, Srinivasan Rajagopalan, Ronald Karwoski, Arjun Nair, Simon L.F. Walsh, Joseph Barnett, Gary Cross, Eoin P. Judge, Maria Kokosi, Elisabetta Renzoni, Toby M. Maher, Athol U. Wells

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and objective: This study evaluated whether patients with combined pulmonary fibrosis and emphysema (CPFE) have an increased likelihood of pulmonary hypertension (PHT) when compared with idiopathic pulmonary fibrosis (IPF) patients without emphysema. Methods: Two consecutive IPF populations having undergone transthoracic echocardiography were examined (n =223 and n =162). Emphysema and interstitial lung disease (ILD) extent were quantified visually; ILD extent was also quantified by a software tool, CALIPER. Echocardiographic criteria categorized PHT risk. Results: The prevalence of an increased PHT likelihood was 29% and 31% in each CPFE cohort. Survival at 12months was 60% across both CPFE cohorts with no significantly worsened outcome identified when compared with IPF patients without emphysema. Using logistic regression models in both cohorts, total computed tomography (CT) disease extent (ILD and emphysema) predicted the likelihood of PHT. After adjustment for total disease extent, CPFE had no stronger association with PHT likelihood than IPF patients without emphysema. Conclusion: Our findings indicate that the reported association between CPFE and PHT is explained by the summed baseline CT extents of ILD and emphysema. Once baseline severity is taken into account, CPFE is not selectively associated with a malignant microvascular phenotype, when compared with IPF patients without emphysema.

Original languageEnglish (US)
JournalRespirology
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Pulmonary Emphysema
Idiopathic Pulmonary Fibrosis
Emphysema
Pulmonary Fibrosis
Pulmonary Hypertension
Interstitial Lung Diseases
Logistic Models
Tomography
Echocardiography
Software
Phenotype
Survival
Population

Keywords

  • Computer tomography
  • Emphysema
  • Idiopathic pulmonary fibrosis
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Jacob, J., Bartholmai, B. J., Rajagopalan, S., Karwoski, R., Nair, A., Walsh, S. L. F., ... Wells, A. U. (Accepted/In press). Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema. Respirology. https://doi.org/10.1111/resp.13231

Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema. / Jacob, Joseph; Bartholmai, Brian Jack; Rajagopalan, Srinivasan; Karwoski, Ronald; Nair, Arjun; Walsh, Simon L.F.; Barnett, Joseph; Cross, Gary; Judge, Eoin P.; Kokosi, Maria; Renzoni, Elisabetta; Maher, Toby M.; Wells, Athol U.

In: Respirology, 01.01.2017.

Research output: Contribution to journalArticle

Jacob, J, Bartholmai, BJ, Rajagopalan, S, Karwoski, R, Nair, A, Walsh, SLF, Barnett, J, Cross, G, Judge, EP, Kokosi, M, Renzoni, E, Maher, TM & Wells, AU 2017, 'Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema', Respirology. https://doi.org/10.1111/resp.13231
Jacob, Joseph ; Bartholmai, Brian Jack ; Rajagopalan, Srinivasan ; Karwoski, Ronald ; Nair, Arjun ; Walsh, Simon L.F. ; Barnett, Joseph ; Cross, Gary ; Judge, Eoin P. ; Kokosi, Maria ; Renzoni, Elisabetta ; Maher, Toby M. ; Wells, Athol U. / Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema. In: Respirology. 2017.
@article{80e9dd0c69434576810b5ac611ab865c,
title = "Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema",
abstract = "Background and objective: This study evaluated whether patients with combined pulmonary fibrosis and emphysema (CPFE) have an increased likelihood of pulmonary hypertension (PHT) when compared with idiopathic pulmonary fibrosis (IPF) patients without emphysema. Methods: Two consecutive IPF populations having undergone transthoracic echocardiography were examined (n =223 and n =162). Emphysema and interstitial lung disease (ILD) extent were quantified visually; ILD extent was also quantified by a software tool, CALIPER. Echocardiographic criteria categorized PHT risk. Results: The prevalence of an increased PHT likelihood was 29{\%} and 31{\%} in each CPFE cohort. Survival at 12months was 60{\%} across both CPFE cohorts with no significantly worsened outcome identified when compared with IPF patients without emphysema. Using logistic regression models in both cohorts, total computed tomography (CT) disease extent (ILD and emphysema) predicted the likelihood of PHT. After adjustment for total disease extent, CPFE had no stronger association with PHT likelihood than IPF patients without emphysema. Conclusion: Our findings indicate that the reported association between CPFE and PHT is explained by the summed baseline CT extents of ILD and emphysema. Once baseline severity is taken into account, CPFE is not selectively associated with a malignant microvascular phenotype, when compared with IPF patients without emphysema.",
keywords = "Computer tomography, Emphysema, Idiopathic pulmonary fibrosis, Pulmonary hypertension",
author = "Joseph Jacob and Bartholmai, {Brian Jack} and Srinivasan Rajagopalan and Ronald Karwoski and Arjun Nair and Walsh, {Simon L.F.} and Joseph Barnett and Gary Cross and Judge, {Eoin P.} and Maria Kokosi and Elisabetta Renzoni and Maher, {Toby M.} and Wells, {Athol U.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1111/resp.13231",
language = "English (US)",
journal = "Respirology",
issn = "1323-7799",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Likelihood of pulmonary hypertension in patients with idiopathic pulmonary fibrosis and emphysema

AU - Jacob, Joseph

AU - Bartholmai, Brian Jack

AU - Rajagopalan, Srinivasan

AU - Karwoski, Ronald

AU - Nair, Arjun

AU - Walsh, Simon L.F.

AU - Barnett, Joseph

AU - Cross, Gary

AU - Judge, Eoin P.

AU - Kokosi, Maria

AU - Renzoni, Elisabetta

AU - Maher, Toby M.

AU - Wells, Athol U.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background and objective: This study evaluated whether patients with combined pulmonary fibrosis and emphysema (CPFE) have an increased likelihood of pulmonary hypertension (PHT) when compared with idiopathic pulmonary fibrosis (IPF) patients without emphysema. Methods: Two consecutive IPF populations having undergone transthoracic echocardiography were examined (n =223 and n =162). Emphysema and interstitial lung disease (ILD) extent were quantified visually; ILD extent was also quantified by a software tool, CALIPER. Echocardiographic criteria categorized PHT risk. Results: The prevalence of an increased PHT likelihood was 29% and 31% in each CPFE cohort. Survival at 12months was 60% across both CPFE cohorts with no significantly worsened outcome identified when compared with IPF patients without emphysema. Using logistic regression models in both cohorts, total computed tomography (CT) disease extent (ILD and emphysema) predicted the likelihood of PHT. After adjustment for total disease extent, CPFE had no stronger association with PHT likelihood than IPF patients without emphysema. Conclusion: Our findings indicate that the reported association between CPFE and PHT is explained by the summed baseline CT extents of ILD and emphysema. Once baseline severity is taken into account, CPFE is not selectively associated with a malignant microvascular phenotype, when compared with IPF patients without emphysema.

AB - Background and objective: This study evaluated whether patients with combined pulmonary fibrosis and emphysema (CPFE) have an increased likelihood of pulmonary hypertension (PHT) when compared with idiopathic pulmonary fibrosis (IPF) patients without emphysema. Methods: Two consecutive IPF populations having undergone transthoracic echocardiography were examined (n =223 and n =162). Emphysema and interstitial lung disease (ILD) extent were quantified visually; ILD extent was also quantified by a software tool, CALIPER. Echocardiographic criteria categorized PHT risk. Results: The prevalence of an increased PHT likelihood was 29% and 31% in each CPFE cohort. Survival at 12months was 60% across both CPFE cohorts with no significantly worsened outcome identified when compared with IPF patients without emphysema. Using logistic regression models in both cohorts, total computed tomography (CT) disease extent (ILD and emphysema) predicted the likelihood of PHT. After adjustment for total disease extent, CPFE had no stronger association with PHT likelihood than IPF patients without emphysema. Conclusion: Our findings indicate that the reported association between CPFE and PHT is explained by the summed baseline CT extents of ILD and emphysema. Once baseline severity is taken into account, CPFE is not selectively associated with a malignant microvascular phenotype, when compared with IPF patients without emphysema.

KW - Computer tomography

KW - Emphysema

KW - Idiopathic pulmonary fibrosis

KW - Pulmonary hypertension

UR - http://www.scopus.com/inward/record.url?scp=85038000435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038000435&partnerID=8YFLogxK

U2 - 10.1111/resp.13231

DO - 10.1111/resp.13231

M3 - Article

C2 - 29237236

AN - SCOPUS:85038000435

JO - Respirology

JF - Respirology

SN - 1323-7799

ER -