Baseline pulmonary function tests help determine survival in ILD without pulmonary hypertension
Baseline pulmonary function tests may help determine mortality risk in patients with interstitial lung disease (ILD) without pulmonary hypertension (PH), according to a study.
In this study, 169 consecutive patients with ILD who underwent right heart catheterization were analyzed for demographics and physiological and hemodynamic parameters of survival.
Overall, 33 patients died and 2 underwent transplantation. A predicted diffusion capacity of the lung for carbon monoxide <35%, walking distance <300 m, and final oxygen saturation measured by pulse oximetry <85% after a 6-minute walk test were significantly associated with an increased mortality risk. Older age, a diagnosis of idiopathic pulmonary fibrosis, reduced forced vital capacity, and low cardiac index were independent predictors of increased mortality in patients with ILD.
“Importantly, cardiac index was the only hemodynamic variable independently associated with survival,” the authors concluded. “Thus, in the absence of PH, when ILD patients perform poorly during the 6MWT manifested as reduced walking distance and desaturation at the end of the test, cardiovascular impairment must be ruled out.”
Alhamad EH, Cal JG. Predictors of mortality in interstitial lung disease patients without pulmonary hypertension. Ann Thorac Med. 2020;15(4):238-243. DOI: 10.4103/atm.ATM_438_20. Epub 2020 Oct 10. PMID: 33381239; PMCID: PMC7720737.