Pulmonary Arterial Hypertension in Thai Patients with Systemic Sclerosis
Suparaporn Wangkaew MD*, Nuntana Kasitanon MD*, Arintaya Phrommintikul MD**, Waraporn Sukitawut MD*, Ramjai Wichainun MD*, Worawit Louthrenoo MD*
Affiliation : * Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai ** Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : Study the clinical features of pulmonary arterial hypertension (PAH) in Thai patients with systemic
sclerosis (SSc), and compare these features between those with limited (lc) SSc and diffuse (dc) SSc.
Material and Method: The medical records of SSc patients attending the Division of Rheumatology, Chiang
Mai University were reviewed. PAH was defined by pulmonary arterial systolic pressure (PASP) > 35 mmHg,
determined by Doppler echocardiography.
Results : Among 275 patients with SSc, 66 had Doppler echocardiography measurement. Thirty-nine patients
(59.1%) had PAH. Among the PAH-SSc patients, 36 (92.3%) presented with dyspnea on exertion, and 37
(94.8%) were in a New York Heart Association functional class of II and III. Twenty-four of 39 patients (61.5%)
had interstitial lung disease. Diffuse SSc patients had a significantly higher proportion of males, and shorter
disease duration between SSc and PAH diagnosis than lcSSc patients.
Conclusion : PAH was not uncommon in Thai patients with SSc. Interstitial lung disease might have been the
cause associated with over half of these cases. Annual routine Doppler echocardiography screening for PAH
in patients with SSc may detect preclinical PAH, and lead to early management and improved functional
outcome.
Keywords : Scleroderma, Systemic sclerosis, Pulmonary arterial hypertension
