Screening and management of pulmonary arterial hypertension in systemic sclerosis

Systemic sclerosis-associated pulmonary hypertension (SSc-PH) and pulmonary arterial (PA) hypertension (SSc-PAH) are well-recognized manifestations. SSc-PH is a hemodynamic observation, and it is important to identify underlying etiology. SSc patients commonly have mixed etiology for SSc-PH due to i...

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Main Authors: Vivek Nagaraja, Dinesh Khanna
Format: Article
Language:English
Published: SAGE Publishing 2017-01-01
Series:Indian Journal of Rheumatology
Subjects:
Online Access:http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=6;spage=204;epage=210;aulast=Nagaraja
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author Vivek Nagaraja
Dinesh Khanna
author_facet Vivek Nagaraja
Dinesh Khanna
author_sort Vivek Nagaraja
collection DOAJ
description Systemic sclerosis-associated pulmonary hypertension (SSc-PH) and pulmonary arterial (PA) hypertension (SSc-PAH) are well-recognized manifestations. SSc-PH is a hemodynamic observation, and it is important to identify underlying etiology. SSc patients commonly have mixed etiology for SSc-PH due to interstitial lung disease, PAH, and left heart disease. SSc-PAH is associated with high morbidity and mortality. Early detection of PAH through routine screening improves survival in patients with SSc. Right heart catheterization is mandatory to diagnose PAH. SSc-PAH patients should be managed by a multidisciplinary team comprising of rheumatologist, pulmonologist, cardiologist, and physiotherapist. Various pharmacotherapy options to treat SSc-PAH are derived from the idiopathic PAH management. Upfront or sequential combination therapy of PAH-specific drugs seems to confer a clinical benefit compared to monotherapy. Cardiopulmonary rehabilitation should be considered as a part of the management plan. Lung transplantation is a consideration in patients who are not responding to pharmacotherapy. Although the long-term prognosis of SSc-PAH has been historically poor, the landscape is gradually changing with early detection and institution of treatment.
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spelling doaj-art-c9a4868fd68c414f89834bca09794f5e2025-01-02T04:57:33ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012017-01-01126204210Screening and management of pulmonary arterial hypertension in systemic sclerosisVivek NagarajaDinesh KhannaSystemic sclerosis-associated pulmonary hypertension (SSc-PH) and pulmonary arterial (PA) hypertension (SSc-PAH) are well-recognized manifestations. SSc-PH is a hemodynamic observation, and it is important to identify underlying etiology. SSc patients commonly have mixed etiology for SSc-PH due to interstitial lung disease, PAH, and left heart disease. SSc-PAH is associated with high morbidity and mortality. Early detection of PAH through routine screening improves survival in patients with SSc. Right heart catheterization is mandatory to diagnose PAH. SSc-PAH patients should be managed by a multidisciplinary team comprising of rheumatologist, pulmonologist, cardiologist, and physiotherapist. Various pharmacotherapy options to treat SSc-PAH are derived from the idiopathic PAH management. Upfront or sequential combination therapy of PAH-specific drugs seems to confer a clinical benefit compared to monotherapy. Cardiopulmonary rehabilitation should be considered as a part of the management plan. Lung transplantation is a consideration in patients who are not responding to pharmacotherapy. Although the long-term prognosis of SSc-PAH has been historically poor, the landscape is gradually changing with early detection and institution of treatment.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=6;spage=204;epage=210;aulast=NagarajaPulmonary arterial hypertensionpulmonary hypertensionsystemic sclerosis
spellingShingle Vivek Nagaraja
Dinesh Khanna
Screening and management of pulmonary arterial hypertension in systemic sclerosis
Indian Journal of Rheumatology
Pulmonary arterial hypertension
pulmonary hypertension
systemic sclerosis
title Screening and management of pulmonary arterial hypertension in systemic sclerosis
title_full Screening and management of pulmonary arterial hypertension in systemic sclerosis
title_fullStr Screening and management of pulmonary arterial hypertension in systemic sclerosis
title_full_unstemmed Screening and management of pulmonary arterial hypertension in systemic sclerosis
title_short Screening and management of pulmonary arterial hypertension in systemic sclerosis
title_sort screening and management of pulmonary arterial hypertension in systemic sclerosis
topic Pulmonary arterial hypertension
pulmonary hypertension
systemic sclerosis
url http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=6;spage=204;epage=210;aulast=Nagaraja
work_keys_str_mv AT viveknagaraja screeningandmanagementofpulmonaryarterialhypertensioninsystemicsclerosis
AT dineshkhanna screeningandmanagementofpulmonaryarterialhypertensioninsystemicsclerosis