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(Chest. 2005;128:1483-1489.)
© 2005 American College of Chest Physicians

Distinctive Clinical, Radiographic, and Functional Characteristics of Patients With Sarcoidosis-Related Pulmonary Hypertension*

Roxana Sulica, MD; Alvin S. Teirstein, MD; Shudhir Kakarla, MD; Nimish Nemani, MD; Anousheh Behnegar, MD and Maria L. Padilla, MD

* From the Pulmonary, Critical Care, and Sleep Division, Mount Sinai School of Medicine, New York, NY.

Correspondence to: Maria L. Padilla, MD, Pulmonary, Critical Care, and Sleep Division, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1232, New York, NY 10029; e-mail: maria.padilla{at}mssm.edu

Study objective: To differentiate the clinical, radiographic, and physiologic profile in patients with sarcoidosis with and without pulmonary hypertension.

Design: Retrospective survey.

Setting: Tertiary care center.

Patients: One hundred six patients with sarcoidosis were classified by two-dimensional echocardiography into two groups: group 1, 54 patients with pulmonary hypertension; group 2, 52 patients without pulmonary hypertension.

Interventions: Patients underwent two-dimensional and Doppler echocardiography, chest radiography (CXR), pulmonary function testing, and arterial oxygen saturation determination, and the test results were compared between the two groups. Statistical analysis was performed using independent-sample t test and {chi}2 test, as appropriate; p < 0.05 was considered to be significant.

Results: Predicted spirometric values and lung diffusing capacity were significantly lower in patients in group 1 compared to patients in group 2: FVC, 54% vs 64% (p = 0.0065), FEV1, 47% vs 61% (p = 0.0005), forced expiratory flow, midexpiratory phase, 35% vs 52% (p = 0.0363), and single-breath diffusing capacity of the lung for carbon monoxide (DLCOsb), 39% vs 54% (p = 0.0001). Sixty percent of patients in group 1 had radiographic Scadding stage 4 sarcoidosis, while no radiographic stage predominated in group 2. Arterial oxygen saturation, need for oxygen supplementation, and degree of desaturation after exercise did not differ between groups.

Conclusions: The presence of pulmonary hypertension in patients with sarcoidosis is associated with higher prevalence of stage 4 sarcoidosis by CXR and lower predicted spirometric and DLCOsb measurements.

Key Words: chest radiography • echocardiography • oxygen saturation • pulmonary function • pulmonary hypertension • sarcoidosis




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